Active NPI 1619950383 Individual Practitioner Male Practitioner

Dr. Temitope F Soares , MD

Dermatology • Spring, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Temitope Soares, MD is a certified Dermatology practicing in Spring, TX. With approximately 22 years of clinical experience since graduating from Medical College Of Georgia School Of Medicine in 2004, Dr. Soares delivers high-quality medical care to the local community at 28517 SPRING TRAILS RIDGE.

Dr. Soares accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

28517 Spring Trails Ridge
110

Spring, TX 773864357

Telephone 2813858189

Fax 2812035037

Associated Practice Facility / Clinic

🏢 Advanced Associates In Dermatology, Pllc Facility NPI 1134447949

Medicare Profile & Education

Medical School

Medical College Of Georgia School Of Medicine

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Spring, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs +9.4 yrs vs City Avg

City Avg: 12.6 Yrs

State Avg: 20.2 Yrs

Regional Practice Density

5 Specialists

Practicing in Spring, TX (1210 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

55.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Soares (22 Years) 22 Yrs

Spring Specialty Average (12.6 Years) 12.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	626	81	$12.67	$6.24
99213 Established patient office or other outpatient visit, typically 15 minutes	289	207	$175.79	$86.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	169	126	$248.25	$122.61
17000 Destruction of skin growth	123	102	$130.05	$51.63
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	86	12	$1.97	$0.97
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	71	59	$290.09	$122.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$215.59	$105.30
17110 Destruction of up to 14 skin growths	59	51	$217.82	$93.72
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	49	42	$296.87	$137.73
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	47	41	$262.14	$100.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	29	$109.07	$53.77
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	27	25	$346.79	$167.85
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$324.10	$156.01
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	22	21	$265.03	$95.11
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	22	18	$279.77	$112.95
11104 Punch biopsy, first skin growth	22	22	$238.46	$104.15
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	20	18	$812.41	$380.46
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	17	16	$594.94	$146.36
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	17	17	$758.88	$373.60
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	16	15	$900.82	$444.14
99202 New patient office or other outpatient visit, typically 20 minutes	16	16	$139.15	$67.19
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	14	11	$372.33	$163.75
17004 Destruction of precancer skin growth, 15 or more growths	13	12	$320.37	$157.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	738	93	$13.00	$6.41
99213 Established patient office or other outpatient visit, typically 15 minutes	289	213	$175.46	$86.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	189	140	$248.49	$122.62
17000 Destruction of skin growth	147	110	$130.47	$47.97
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	117	89	$297.26	$127.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$217.38	$106.79
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	62	50	$354.14	$168.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	49	$109.76	$54.00
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	52	45	$267.79	$90.11
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	52	47	$305.17	$127.33
17110 Destruction of up to 14 skin growths	51	49	$220.91	$81.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$323.90	$157.25
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	35	31	$287.14	$109.07
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	31	23	$829.39	$375.98
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	28	27	$919.18	$445.15
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	27	16	$247.76	$122.01
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	26	17	$605.38	$160.39
11104 Punch biopsy, first skin growth	21	20	$244.90	$109.07
17004 Destruction of precancer skin growth, 15 or more growths	20	18	$328.88	$161.81
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	17	15	$775.96	$325.63
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	17	17	$272.28	$102.57
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$140.63	$69.35
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	12	12	$376.56	$169.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	743	106	$13.34	$6.61
99213 Established patient office or other outpatient visit, typically 15 minutes	290	203	$177.30	$87.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	113	$250.76	$123.62
17000 Destruction of skin growth	149	114	$131.64	$50.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	102	102	$218.08	$108.10
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	101	14	$2.25	$1.12
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	70	61	$302.22	$132.53
17110 Destruction of up to 14 skin growths	64	55	$222.88	$91.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	52	$110.10	$54.50
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	48	44	$274.10	$108.70
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	43	40	$308.32	$122.68
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	41	38	$359.26	$175.86
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	29	26	$296.26	$121.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$325.82	$161.88
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	26	22	$841.78	$384.40
17004 Destruction of precancer skin growth, 15 or more growths	24	19	$331.68	$164.63
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	22	20	$279.18	$106.66
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	22	20	$931.54	$450.23
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	21	17	$608.36	$150.77
11104 Punch biopsy, first skin growth	20	20	$250.78	$115.20
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	14	11	$249.20	$123.61
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	11	11	$787.20	$355.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	519	79	$12.59	$6.34
99213 Established patient office or other outpatient visit, typically 15 minutes	264	192	$174.37	$89.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	126	98	$249.80	$125.77
17000 Destruction of skin growth	125	95	$129.80	$49.52
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	108	108	$218.67	$109.00
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	93	75	$308.41	$133.42
17110 Destruction of up to 14 skin growths	75	65	$223.84	$85.86
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	66	57	$366.18	$173.52
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	62	54	$315.26	$129.86
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	52	49	$279.56	$109.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	47	$107.59	$55.09
17004 Destruction of precancer skin growth, 15 or more growths	48	41	$321.01	$163.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$327.83	$164.39
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	35	32	$304.44	$129.08
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	28	27	$857.14	$375.45
11104 Punch biopsy, first skin growth	20	20	$254.86	$118.64
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	19	$289.09	$105.64
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	18	16	$615.81	$154.41
99202 New patient office or other outpatient visit, typically 20 minutes	18	18	$142.61	$71.31
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	16	14	$943.59	$434.66
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	15	15	$802.25	$336.62
17283 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm	13	13	$478.24	$240.71
13122 Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less	11	11	$259.96	$127.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	387	67	$11.00	$5.82
99213 Established patient office or other outpatient visit, typically 15 minutes	211	152	$150.00	$73.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	129	109	$222.00	$105.98
17000 Destruction of skin growth	106	87	$137.00	$50.59
99202 New patient office or other outpatient visit, typically 20 minutes	96	96	$154.43	$73.32
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	70	62	$324.00	$130.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$222.00	$104.48
17110 Destruction of up to 14 skin growths	52	50	$232.00	$88.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	47	44	$89.15	$44.37
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	45	39	$293.00	$101.10
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	45	41	$333.00	$139.46
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	37	34	$387.00	$174.81
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	31	30	$314.00	$130.52
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	30	27	$301.00	$106.27
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	29	27	$987.00	$440.21
17004 Destruction of precancer skin growth, 15 or more growths	25	23	$299.00	$144.33
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	21	21	$885.00	$373.50
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	13	13	$654.00	$154.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	517	72	$11.00	$5.43
99213 Established patient office or other outpatient visit, typically 15 minutes	263	191	$150.00	$72.11
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	151	124	$222.00	$105.97
17000 Destruction of skin growth	119	99	$137.00	$49.24
99202 New patient office or other outpatient visit, typically 20 minutes	112	112	$155.00	$73.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	99	99	$222.00	$105.97
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	94	86	$324.00	$131.98
17110 Destruction of up to 14 skin growths	70	66	$232.00	$82.83
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	61	52	$333.00	$140.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	53	$90.00	$43.62
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	50	45	$387.00	$172.06
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	45	41	$314.00	$121.00
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	44	12	$15.00	$1.60
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	37	36	$293.00	$108.64
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	35	30	$301.00	$97.83
17004 Destruction of precancer skin growth, 15 or more growths	35	30	$299.00	$143.75
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	34	30	$885.00	$370.43
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	28	27	$987.00	$450.08
11644 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm	17	16	$819.00	$191.87
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	14	12	$654.00	$152.86
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	13	13	$397.00	$168.57
11104 Punch biopsy, first skin growth	12	12	$240.00	$110.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	345	58	$11.00	$5.02
99213 Established patient office or other outpatient visit, typically 15 minutes	206	144	$147.45	$70.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	122	100	$215.76	$104.01
17000 Destruction of skin growth	103	79	$136.18	$50.62
99202 New patient office or other outpatient visit, typically 20 minutes	95	95	$153.84	$72.85
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	85	75	$322.31	$131.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	73	73	$220.81	$104.55
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	68	58	$378.35	$170.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	49	$89.26	$42.17
17004 Destruction of precancer skin growth, 15 or more growths	50	42	$295.08	$139.15
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	35	34	$325.11	$125.82
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	34	29	$309.76	$122.44
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	33	32	$280.45	$92.69
17110 Destruction of up to 14 skin growths	28	28	$222.14	$80.71
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	21	18	$969.52	$424.81
11100 Biopsy of single growth of skin and/or tissue	21	21	$218.00	$75.03
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	15	$291.88	$87.22
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	15	13	$885.00	$368.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	288	54	$12.00	$5.31
99213 Established patient office or other outpatient visit, typically 15 minutes	148	123	$85.00	$69.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	140	113	$125.00	$102.92
99202 New patient office or other outpatient visit, typically 20 minutes	83	83	$100.00	$71.05
17000 Destruction of skin growth	76	68	$95.00	$52.11
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	75	70	$180.00	$140.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	55	55	$135.00	$103.21
17110 Destruction of up to 14 skin growths	47	45	$140.00	$76.74
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	46	43	$195.02	$137.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	38	$50.00	$41.40
17004 Destruction of precancer skin growth, 15 or more growths	40	34	$250.00	$142.67
11313 Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth	40	36	$240.00	$170.71
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	30	28	$155.00	$98.56
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	22	22	$620.00	$432.38
11308 Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm	20	19	$170.00	$129.51
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	19	18	$525.00	$394.84
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	14	14	$321.79	$149.95
11644 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm	14	14	$400.00	$187.88
11100 Biopsy of single growth of skin and/or tissue	12	12	$140.00	$65.33

Medical Specialties & State Licenses

CMS Verified: 2025-08-08

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License TX M9017

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Kristen Garrett , PA-C

Physician Assistant

NPI 1013352434

Physician Assistant (Certified)

Ricky Flory , FNP-C

Nurse Practitioner - Family

NPI 1508710245

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Business Mailing Address August 08, 2025

Registered at 28517 SPRING TRAILS RDG STE 110, SPRING, TX 773864357 (Tel: 2813858189)

📍

Updated Business Mailing Address March 31, 2022

Registered at 4919 MEMORIAL HWY STE 150, TAMPA, FL 336347516 (Tel: 8133331512)

✅

NPI Profile Active February 03, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location February 03, 2016

Registered at 28517 SPRING TRAILS RIDGE, 110, SPRING, TX 773864357 (Tel: 2813858189)

📍

Updated Business Mailing Address February 03, 2016

Registered at 28517 SPRING TRAILS RIDGE, 110, SPRING, TX 773864357 (Tel: 2813858189)

👤

Provider Name / Credentials Updated February 03, 2016

Recorded as TEMITOPE SOARES, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 03, 2016

Dermatology (License #M9017 in TX)

🟢

Initial NPI Registration & Enumeration November 27, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1619950383

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 27, 2005

Last Update: August 08, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

28517 Spring Trails Rdg Ste 110

Spring, TX 773864357

Phone: 2813858189

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.