Active NPI 1487074084 Individual Practitioner Male Practitioner

Dr. Gregory Walker , MD, MBA

Dermatology • Waco, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Gregory Walker, MD, MBA is a certified Dermatology practicing in Waco, TX. With approximately 12 years of clinical experience since graduating from Texas Tech University Health Science Center School Of Medicine in 2014, Dr. Walker delivers high-quality medical care to the local community at 300 RICHLAND WEST CIR STE 2C.

Dr. Walker is affiliated with Oliver Street 5.01(A) Inc and 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

300 Richland West Cir Ste 2c

Waco, TX 767127935

Telephone 2543406000

Fax 2543406010

Associated Practice Facility / Clinic

🏢 Oliver Street 5.01(A) Inc. Facility NPI 1457695413

Medicare Profile & Education

Medical School

Texas Tech University Health Science Center School Of Medicine

Graduation Year

2014

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Waco, TX

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

12 Yrs -2.8 yrs vs City Avg

City Avg: 14.8 Yrs

State Avg: 20.2 Yrs

Regional Practice Density

10 Specialists

Practicing in Waco, TX (1210 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

77.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Walker (12 Years) 12 Yrs

Waco Specialty Average (14.8 Years) 14.8 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	2,067	305	$23.00	$6.60
99213 Established patient office or other outpatient visit, typically 15 minutes	678	468	$309.00	$91.26
17000 Destruction of skin growth	514	360	$231.00	$55.18
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	293	227	$2309.00	$642.79
11102 Tangential biopsy of single skin lesion	245	201	$341.00	$92.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	211	159	$435.00	$129.40
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	161	96	$1402.00	$414.06
17110 Destruction of up to 14 skin growths	118	98	$388.00	$107.91
11103 Biopsy of related skin growth, each additional growth	102	64	$171.00	$50.20
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	77	66	$1032.00	$267.39
17004 Destruction of precancer skin growth, 15 or more growths	66	52	$570.00	$167.66
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	62	60	$1072.00	$159.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	60	60	$379.00	$112.17
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	59	51	$51.00	$16.71
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	57	53	$1595.00	$236.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	47	46	$192.00	$55.37
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	29	25	$948.00	$139.59
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	26	25	$964.00	$142.61
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	26	24	$833.00	$123.39
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	26	21	$608.00	$143.57
69100 Biopsy of ear	25	22	$325.00	$68.84
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	20	20	$1441.00	$224.42
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	20	19	$2615.00	$777.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$567.00	$167.23
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	17	15	$1054.00	$229.57
11104 Punch biopsy, first skin growth	14	12	$425.00	$124.11
13151 Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm	12	12	$1433.00	$212.82
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	12	11	$1235.00	$182.01
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	12	12	$2171.00	$639.57
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	11	11	$1683.00	$249.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,898	296	$23.00	$6.49
99213 Established patient office or other outpatient visit, typically 15 minutes	676	466	$297.00	$87.36
17000 Destruction of skin growth	495	362	$223.00	$51.84
11102 Tangential biopsy of single skin lesion	248	207	$338.00	$92.14
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	246	202	$2249.00	$628.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	232	177	$420.00	$123.81
17110 Destruction of up to 14 skin growths	132	117	$378.00	$106.89
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	119	90	$1366.00	$396.89
11103 Biopsy of related skin growth, each additional growth	98	62	$168.00	$48.52
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	96	96	$369.00	$108.59
17004 Destruction of precancer skin growth, 15 or more growths	74	57	$562.00	$164.03
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	69	63	$1052.00	$156.04
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	68	60	$1011.00	$258.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	47	$186.00	$54.76
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	38	37	$1568.00	$229.58
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	35	32	$813.00	$122.34
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	30	30	$946.00	$147.33
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	29	23	$594.00	$146.81
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	27	27	$1031.00	$195.50
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$547.00	$161.55
69100 Biopsy of ear	25	22	$321.00	$75.09
11104 Punch biopsy, first skin growth	19	16	$419.00	$115.70
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	18	18	$1415.00	$230.13
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	17	16	$2112.00	$618.32
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	17	16	$927.00	$135.65
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$238.00	$68.72
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	13	13	$1653.00	$227.57
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	11	11	$2543.00	$745.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,606	254	$23.00	$6.60
99213 Established patient office or other outpatient visit, typically 15 minutes	619	440	$295.00	$87.24
17000 Destruction of skin growth	432	322	$221.00	$51.25
11102 Tangential biopsy of single skin lesion	252	207	$338.00	$92.31
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	249	191	$2200.00	$615.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	209	155	$416.00	$123.38
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	130	86	$1341.00	$389.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	116	116	$365.00	$107.97
17110 Destruction of up to 14 skin growths	108	100	$374.00	$105.47
11103 Biopsy of related skin growth, each additional growth	106	61	$169.00	$49.81
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	87	77	$1000.00	$257.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	73	67	$184.00	$54.56
17004 Destruction of precancer skin growth, 15 or more growths	65	48	$554.00	$160.35
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	62	60	$1558.00	$223.33
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	55	51	$1045.00	$162.87
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	43	40	$804.00	$124.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$543.00	$161.18
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	30	27	$915.00	$135.56
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	28	27	$942.00	$145.78
69100 Biopsy of ear	24	20	$319.00	$62.88
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	21	18	$587.00	$152.96
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	20	20	$1408.00	$250.79
11104 Punch biopsy, first skin growth	20	18	$420.00	$124.45
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	17	17	$1027.00	$178.78
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$237.00	$70.38
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	12	11	$2068.00	$572.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,784	272	$21.13	$6.36
99213 Established patient office or other outpatient visit, typically 15 minutes	609	407	$289.33	$88.80
17000 Destruction of skin growth	469	339	$212.83	$50.97
11102 Tangential biopsy of single skin lesion	277	231	$335.03	$94.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	181	126	$409.99	$126.34
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	180	155	$2173.30	$642.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	143	143	$358.39	$108.80
11103 Biopsy of related skin growth, each additional growth	119	76	$171.02	$51.97
17110 Destruction of up to 14 skin growths	106	92	$365.53	$108.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	96	87	$177.81	$54.83
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	83	58	$1311.61	$403.61
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	79	71	$995.25	$269.27
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	56	54	$1548.42	$236.29
17004 Destruction of precancer skin growth, 15 or more growths	51	41	$531.40	$160.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$534.70	$164.04
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	40	37	$800.08	$119.62
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	33	33	$908.00	$142.61
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	27	27	$1024.00	$161.67
11104 Punch biopsy, first skin growth	26	25	$420.00	$128.01
69100 Biopsy of ear	25	19	$319.73	$63.76
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	25	24	$1404.00	$244.31
99202 New patient office or other outpatient visit, typically 20 minutes	25	25	$235.22	$68.34
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	22	17	$575.00	$147.77
17111 Destruction of skin growth, 15 or more growths	14	13	$427.79	$130.85
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	14	14	$1006.00	$230.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,584	254	$17.43	$5.83
99213 Established patient office or other outpatient visit, typically 15 minutes	551	406	$173.47	$72.88
17000 Destruction of skin growth	394	315	$153.25	$50.52
11102 Tangential biopsy of single skin lesion	227	193	$237.59	$90.91
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	198	177	$261.18	$105.67
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	161	128	$1576.17	$622.20
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	119	64	$951.88	$380.09
99202 New patient office or other outpatient visit, typically 20 minutes	114	114	$179.47	$73.85
17110 Destruction of up to 14 skin growths	97	90	$272.60	$107.03
11103 Biopsy of related skin growth, each additional growth	93	66	$127.17	$51.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	77	77	$254.29	$103.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	72	69	$111.17	$44.07
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	72	66	$1149.17	$242.35
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	33	31	$726.83	$277.29
17004 Destruction of precancer skin growth, 15 or more growths	31	24	$356.15	$154.08
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	30	28	$688.70	$137.33
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	25	24	$990.08	$277.30
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	21	$578.41	$120.53
69100 Biopsy of ear	19	15	$232.74	$72.95
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	19	17	$907.42	$370.33
11104 Punch biopsy, first skin growth	14	14	$290.29	$121.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,874	302	$14.10	$5.33
99213 Established patient office or other outpatient visit, typically 15 minutes	535	395	$151.00	$71.10
17000 Destruction of skin growth	456	361	$133.00	$48.95
11102 Tangential biopsy of single skin lesion	265	224	$202.00	$83.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	236	219	$221.00	$104.14
99202 New patient office or other outpatient visit, typically 20 minutes	181	181	$155.00	$73.09
17110 Destruction of up to 14 skin growths	167	148	$226.00	$104.06
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	156	136	$1368.00	$594.23
11103 Biopsy of related skin growth, each additional growth	134	78	$109.00	$50.48
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	124	124	$220.00	$103.13
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	89	67	$812.00	$379.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	88	66	$92.00	$43.14
17004 Destruction of precancer skin growth, 15 or more growths	68	55	$311.00	$145.51
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	63	54	$985.00	$250.67
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	46	44	$884.00	$319.26
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	36	31	$509.00	$119.06
11104 Punch biopsy, first skin growth	35	32	$254.00	$118.38
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	23	19	$582.00	$136.23
69100 Biopsy of ear	22	20	$201.00	$70.53
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	20	17	$623.00	$276.79
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	18	18	$616.00	$152.48
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	13	$361.00	$122.22
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	17	17	$821.00	$367.13
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$606.00	$192.80
17313 Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks	13	12	$1279.00	$575.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	476	84	$37.39	$5.02
17000 Destruction of skin growth	108	101	$144.03	$47.56
99202 New patient office or other outpatient visit, typically 20 minutes	99	99	$116.66	$72.13
11100 Biopsy of single growth of skin and/or tissue	89	84	$185.17	$90.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	83	83	$174.25	$103.79
99213 Established patient office or other outpatient visit, typically 15 minutes	58	46	$105.36	$70.25
17110 Destruction of up to 14 skin growths	55	52	$194.63	$105.77
11101 Biopsy of each additional growth of skin and/or tissue	38	28	$85.65	$31.50
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	20	19	$1439.43	$602.61
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	13	13	$797.63	$299.52
69100 Biopsy of ear	13	13	$196.11	$66.87
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	12	11	$1050.65	$305.00

Medical Specialties & State Licenses

CMS Verified: 2020-08-26

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License TX R5338

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.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License TX BP20053749

Hospital & Practice Group Affiliations

Oliver Street 5.01(A) Inc

300 Richland W Cir, Waco, TX 767127935

Phone: 2543406000

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Young Mcmahan , MD

Dermatology

NPI 1013352145

Doctor of Medicine (M.D.)

Kylie Smith , PA-C

Physician Assistant

NPI 1013710532

Physician Assistant (Certified)

Shea Young , PA-C

Physician Assistant

NPI 1912161589

Physician Assistant (Certified)

Career & Practice History Timeline

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

9 Historical Events

📍

Updated Practice Location August 26, 2020

Registered at 300 RICHLAND WEST CIR STE 2C, WACO, TX 767127935 (Tel: 2543406000)

📍

Updated Business Mailing Address August 26, 2020

Registered at 5310 HARVEST HILL RD STE 290, DALLAS, TX 752305826 (Tel: 2144200650)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2020

Dermatology (License #R5338 in TX)

✅

NPI Profile Active May 20, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location May 20, 2015

Registered at 2401 S 31ST ST, DEPARTMENT OF DERMATOLOGY, TEMPLE, TX 765080001 (Tel: 2547249290)

📍

Updated Business Mailing Address May 20, 2015

Registered at 2401 S 31ST ST, DEPARTMENT OF DERMATOLOGY, TEMPLE, TX 765080001 (Tel: 2547249290)

👤

Provider Name / Credentials Updated May 20, 2015

Recorded as GREGORY WALKER, M.D., M.B.A.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 20, 2015

Dermatology (License #BP20053749 in TX)

🟢

Initial NPI Registration & Enumeration April 22, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487074084

Entity Type:

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

Enumeration Date: April 22, 2014

Last Update: August 26, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

5310 Harvest Hill Rd Ste 290

Dallas, TX 752305826

Phone: 2144200650

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.