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: July 19, 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.Information from the official NPPES registry record.

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
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

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

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 this NPI number is:

CLIA Number
45D2159884
Facility Type
Physician Office
Certificate Effective Date
April 30, 2025
Certificate Expiration Date
April 29, 2027
Laboratory Director
SAIRA B. MOMIN
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Skin Surgery Institute (of Dfw) after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Dermatology (MOHS-Micrographic Surgery)
2020 W STATE HIGHWAY 114 STE 340
GRAPEVINE, TX 76051

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063988541, enumerated as an "organization" on October 23, 2018.

The provider is located at 2020 W STATE HIGHWAY 114 STE 340 GRAPEVINE, TX 76051 and the phone number is (817) 464-5000.

Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.