Dermatology Associates Of West Texas, LLP
Dermatology in Lubbock, TX. Organization (NPI-2).
NPI number1679704530
StatusActive
Last updated in NPPESMay 15, 2023
Details
- NPI
- 1679704530
- Entity type
- Organization (NPI-2)
- Legal business name
- Dermatology Associates Of West Texas, LLP
- Organization subpart
- No
- Enumeration date
- Jul 27, 2009
- Certification date
- May 15, 2023
- Last updated
- May 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | J6653 M5588 | TX | Yes |
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | J6653 M5588 | TX | |
| 207ND0900X | Dermatology, Dermatopathology | J6653 M5588 | TX |
Other names
- Paulger & Wisniewski Dermatology, LLP (Former Legal Business Name)
Practice location
2202 Ithaca AveLubbock, TX 79410-1332
Phone 806-797-1202 · Fax 806-797-4854
Mailing address
2202 Ithaca AveLubbock, TX 79410-1332
Phone 806-797-1202 · Fax 806-797-4854
Authorized official
Brent R. Paulger
Partner
8067971202
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