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SKIN SURGERY INSTITUTE (OF DFW)
NPI 1063988541
Dermatology - MOHS-Micrographic Surgery in Grapevine, TX

Active since October 23, 2018CLIA 45D2159884 · Certificate of Compliance
2020 W STATE HIGHWAY 114 STE 340, GRAPEVINE, TX 76051(817) 464-5000 Get Directions Write a Review

NPPES record last updated: November 4, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 4, 2018, Oct 28, 2018 (2 updates tracked since 2018).

About Skin Surgery Institute (of Dfw) NPPES

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

SKIN SURGERY INSTITUTE (OF DFW) (NPI 1063988541) is a healthcare organization registered as a mohs-micrographic surgery in Grapevine, Texas and active in the NPI registry since October 2018. The organization holds a CLIA Certificate of Compliance certificate valid through April 29, 2027 and lists Saira B Momin, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1063988541
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameDERMASURGERY SPECIALIST, PLLC
Location Address2020 W STATE HIGHWAY 114 STE 340Grapevine, TX 76051-8650
Mailing Address2728 Mckinnon St Apt 610Dallas, TX 75201-1636 · (281) 744-6708
Phone(817) 464-5000
Organization SubpartNo
Authorized OfficialSaira B MominOwner/president · (817) 464-5000
Enumeration DateOctober 23, 2018
Last NPPES UpdateNovember 4, 20182 updates tracked since enumeration
✔ NPI 1063988541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
2020 W STATE HIGHWAY 114 STE 340, Grapevine, TX 76051
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Other Names 1

Doing Business AsSkin Surgery Institute (of Dfw)

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 45D2159884

Dermasurgery Specialist, PLLC · Grapevine, TX
Active · expires Apr 29, 2027
CLIA Number45D2159884
Laboratory TypePhysician Office
Certificate Effective DateApril 30, 2025
Certificate Expiration DateApril 29, 2027
Laboratory DirectorSaira B. Momin
Laboratory Phone(817) 410-7700
Laboratory LocationDermasurgery Specialist, PLLC2020 West State Highway 114 Suite 340, Grapevine, TX 76051
CLIA data matches this NPI record on: Address Name
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

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

SAIRA BANOO MOMIN DO
Dermatology (MOHS-Micrographic Surgery)
2020 W STATE HIGHWAY 114 STE 340
GRAPEVINE, TX 76051
Tarrant County (817) 410-7700

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 Dermasurgery Specialist, PLLC's NPI number?

The NPI number for Dermasurgery Specialist, PLLC is 1063988541. It was assigned to this organization in the NPPES registry on October 23, 2018. The provider is doing business as Skin Surgery Institute (of Dfw).

Where is Dermasurgery Specialist, PLLC located?

Dermasurgery Specialist, PLLC is located at 2020 W State Highway 114 Ste 340, Grapevine, TX 76051. The listed phone number is (817) 464-5000.

What is Dermasurgery Specialist, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Dermasurgery Specialist, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D2159884) is associated with this NPI, valid through April 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermasurgery Specialist, PLLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Dermasurgery Specialist, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dermasurgery Specialist, PLLC was last updated on November 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.