Oliver Street Dermatology Asc Llc in Tyler - Ambulatory Surgical
Oliver Street Dermatology Asc Llc - NPI 1700822335
Oliver Street Dermatology Asc Llc is a Ambulatory Surgical in Tyler, Texas. Oliver Street Dermatology Asc Llc practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for Oliver Street Dermatology Asc Llc is 1700822335. The last update date is 2013-02-06.
Oliver Street Dermatology Asc Llc's current location address is 1367 Dominion Plaza, Tyler, Texas. You can contact this provider via phone number 9035346200 and fax number 9039390755. The mailing address for Oliver Street Dermatology Asc Llc is 1367 Dominion Plaza, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Oliver Street Dermatology Asc Llc |
|---|---|
| Address | 1367 Dominion Plaza, Tyler, Texas |
| Phone Number | 9035346200 |
| Fax Number | 9039390755 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRACTICE A |
|---|---|
| Authorized Official Name | Stein Lynne Andrea |
| Credentials | RN |
| Telephone Number | 9035346200 |
NPI Number Detail
| NPI Number | 1700822335 |
|---|---|
| Provider Enumeration Date | 2006-06-21 |
| Last Updated Date | 2013-02-06 |
Provider Mailing Address Detail
| Address | 1367 Dominion Plaza |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757031013 |
| Phone Number | 9035346200 |
| Fax Number | 9039390755 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
| Licence No | 7937 |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00044713 | TX | RAILROAD MEDICARE PTAN | |
| 162384501 | TX | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Oliver Street Dermatology Asc Llc by the Centers for Medicare & Medicaid Services?
The Oliver Street Dermatology Asc Llc has been assigned the NPI (National Provider Identifier) 1700822335 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Oliver Street Dermatology Asc Llc is geographically located?
The Oliver Street Dermatology Asc Llc is physically situated at the following location: 1367 Dominion Plaza, Tyler, TX, 757031013.
What is the Oliver Street Dermatology Asc Llc's specialty and taxonomy code?
The Oliver Street Dermatology Asc Llc's specialty is Ambulatory Surgical, and the corresponding taxonomy code is 261Qa1903X.
When did the Oliver Street Dermatology Asc Llc receive its 1700822335?
The Oliver Street Dermatology Asc Llc was issued its 1700822335 on 2006-06-21, which is the date when the organization was assigned this unique identifier.
When was the Oliver Street Dermatology Asc Llc's information last updated?
The Oliver Street Dermatology Asc Llc's information was last updated on 2013-02-06.
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