Organization · NPI-2

Affilliated Dermatologists Of Corpus Christi P.A.

Clinic/Center · Corpus Christi, TX

NPI number1891828026
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1891828026
Entity type
Organization (NPI-2)
Legal business name
Affilliated Dermatologists Of Corpus Christi P.A.
Organization subpart
No
Enumeration date
Mar 14, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

4521 S Staples St Ste 100
Corpus Christi, TX 78411-2603

Phone 361-993-9363 · Fax 361-993-9366

Mailing address

4521 S Staples St Ste 100
Corpus Christi, TX 78411-2603

Phone 361-993-9363 · Fax 361-993-9366

Authorized official

Donald L. Iden
President
3619939363

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