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WARTHAN DERMATOLOGY CENTER
NPI 1003350760
Dermatology in Nacogdoches, TX

Active since December 14, 2016CLIA 45D0484113 · Certificate of Compliance
4730 NE STALLINGS DR, NACOGDOCHES, TX 75965(936) 564-6107(936) 564-5124 Get Directions Write a Review

NPPES record last updated: December 14, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Warthan Dermatology Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WARTHAN DERMATOLOGY CENTER (NPI 1003350760) is a healthcare organization registered as a dermatology in Nacogdoches, Texas and active in the NPI registry since December 2016. The organization holds a CLIA Certificate of Compliance certificate valid through March 12, 2027 and lists Jaclyn R Hill, Billing, as its authorized official.

NPPES Registry Identity

NPI1003350760
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWARTHAN DERMATOLOGY CENTER
Location Address4730 NE STALLINGS DRNacogdoches, TX 75965-1615
Mailing Address4730 Ne Stallings DrNacogdoches, TX 75965-1615 · (936) 564-6107 · Fax (936) 564-5124
Phone(936) 564-6107
Fax(936) 564-5124
Organization SubpartNo
Authorized OfficialJaclyn R HillBilling · (817) 923-8220
Enumeration DateDecember 14, 2016
✔ NPI 1003350760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in TX · D8472
Definition
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.
4730 NE STALLINGS DR, Nacogdoches, TX 75965
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Other Identifiers 1

Medicare UPINB27426TX

Group Practice 1

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 45D0484113

Warthan Dermatology Nacogdoches PLLC · Nacogdoches, TX
Active · expires Mar 12, 2027
CLIA Number45D0484113
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2025
Certificate Expiration DateMarch 12, 2027
Laboratory DirectorMolly M. Warthan
Laboratory Phone(936) 564-6107
Laboratory LocationWarthan Dermatology Nacogdoches PLLC4730 NE Stallings Dr, Nacogdoches, TX 75965
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LAUREN DAVIS PA-C
Physician Assistant
4730 NE STALLINGS DR
NACOGDOCHES, TX 75965
Nacogdoches County (936) 564-6107
WARTHAN DERMATOLOGY NACOGDOCHES PLLC
Dermatology
4730 NE STALLINGS DR
NACOGDOCHES, TX 75965
Nacogdoches County (936) 564-6107

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Warthan Dermatology Center's NPI number?

The NPI number for Warthan Dermatology Center is 1003350760. It was assigned to this organization in the NPPES registry on December 14, 2016.

Where is Warthan Dermatology Center located?

Warthan Dermatology Center is located at 4730 NE Stallings Dr, Nacogdoches, TX 75965. The listed phone number is (936) 564-6107.

What is Warthan Dermatology Center's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Warthan Dermatology Center hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D0484113) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Warthan Dermatology Center was last updated on December 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.