Organization · NPI-2

Dermatology Specialists Of Laredo PA

Dermatology · Laredo, TX

NPI number1528165404
StatusActive
Last updated in NPPESDec 5, 2007

Details

NPI
1528165404
Entity type
Organization (NPI-2)
Legal business name
Dermatology Specialists Of Laredo PA
Organization subpart
No
Enumeration date
Sep 20, 2006
Last updated
Dec 5, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X DermatologyK9972TXYes

Practice location

2344 Laguna Del Mar Court
Suite 101
Laredo, TX 78045

Phone 956-729-7700 · Fax 956-729-7779

Mailing address

Po Box 452409
Laredo, TX 78045

Phone 956-729-7700

Authorized official

Nedil Aldarondo-Antonini
Physician
9567297700

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