LABORDE DERMATOLOGY, PA NPI 1003006156

Specialist in Houston, TX

NPI 1003006156 Organization Specialist CLIA Number 45D1046810 CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP)

About LABORDE DERMATOLOGY, PA

Laborde Dermatology, Pa is a provider established in Houston, Texas specializing in specialist. The NPI number of Laborde Dermatology, Pa is 1003006156 and was assigned on July 2007. The practitioner's primary taxonomy code is 174400000X with license number L5013 (TX). The provider is registered as an organization and their NPI record was last updated 14 years ago. Laborde Dermatology, Pa operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. Stephen Van Laborde Md (Physician)

The CLIA number of Laborde Dermatology, Pa is 45D1046810 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Laborde Dermatology, Pa in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI

1003006156

Provider NameLABORDE DERMATOLOGY, PA
Provider Location Address1333 WEST LOOP S STE 1425 HOUSTON, TX 77027
Provider Mailing Address1333 WEST LOOP S STE 1425 HOUSTON, TX 77027
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-25-2007
Last Update Date07-25-2007


Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.L5013
License StateTX
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

LABORDE DERMATOLOGY, PA
1333 WEST LOOP S STE 1425
HOUSTON, TX
ZIP 77027
Phone: (713) 960-0700
Fax: (713) 960-0761

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Mailing Address

LABORDE DERMATOLOGY, PA
1333 WEST LOOP S STE 1425
HOUSTON, TX
ZIP 77027
Phone: (713) 960-0700
Fax: (713) 960-0761



Authorized Official

Authorized Official NameMR. STEPHEN VAN LABORDE MD
Authorized Official TitlePHYSICIAN
Authorized Official Phone(713) 960-0700

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003006156 is:

CLIA Number45D1046810
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate for Provider-Performed Microscopy Procedures (PPMP)

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
00646YMEDICARE UPIN (02)TX
8D4448MEDICARE PIN (08)TX

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.