1. Home
  2. Directory
  3. Texas
  4. Live Oak
  5. Dermatology
  6. NPI Profile

LONE STAR STATE DERMATOLOGY CLINIC PLLC
NPI 1053723239
Dermatology - Procedural Dermatology in Live Oak, TX

Active since May 22, 2014
11101 TOEPPERWEIN RD, LIVE OAK, TX 78233(210) 651-3233(210) 651-3234 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lone Star State Dermatology Clinic Pllc NPPES

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

LONE STAR STATE DERMATOLOGY CLINIC PLLC (NPI 1053723239) is a healthcare organization registered as a procedural dermatology in Live Oak, Texas and active in the NPI registry since May 2014. The organization lists Myra Peacock, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1053723239
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameLONE STAR STATE DERMATOLOGY CLINIC PLLC
Location Address11101 TOEPPERWEIN RDLive Oak, TX 78233-3048
Mailing Address11101 Toepperwein RdLive Oak, TX 78233-3048 · (210) 651-3233 · Fax (210) 651-3234
Phone(210) 651-3233
Fax(210) 651-3234
Organization SubpartNo
Authorized OfficialMyra PeacockOffice Manager · (210) 651-3233
Enumeration DateMay 22, 2014
Last NPPES UpdateDecember 20, 2023
NPPES CertifiedDecember 20, 2023
✔ NPI 1053723239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in TX · K8022
Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

11101 TOEPPERWEIN RD, Live Oak, TX 78233
Open in Google Maps ↗

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

Other Providers at the Same Location NPPES

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

DR. JEAN-DENIS BOUCHER M.D.
Dermatology (Procedural Dermatology)
11101 TOEPPERWEIN RD
LIVE OAK, TX 78233
Bexar County (210) 651-3233

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 Lone Star State Dermatology Clinic PLLC's NPI number?

The NPI number for Lone Star State Dermatology Clinic PLLC is 1053723239. It was assigned to this organization in the NPPES registry on May 22, 2014.

Where is Lone Star State Dermatology Clinic PLLC located?

Lone Star State Dermatology Clinic PLLC is located at 11101 Toepperwein Rd, Live Oak, TX 78233. The listed phone number is (210) 651-3233.

What is Lone Star State Dermatology Clinic PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

When was this NPI record last updated?

The NPPES record for Lone Star State Dermatology Clinic PLLC was last updated on December 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.