Organization
FRESH DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE THRASH NGUYEN M.D. (PRESIDENT)
(512) 615-5600
Entity
Organization
Contact information
Practice address
1008 RR 620 S STE 101, LAKEWAY, TX 78734-5632
(512) 615-5600
(512) 615-5606
Mailing address
1008 RR 620 S STE 101, LAKEWAY, TX 78734-5632
(512) 615-5600
(512) 615-5606
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
L8216
TX
Other
Enumeration date
09/15/2013
Last updated
09/15/2013
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