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FAIRVIEW DERMATOLOGY PLLC
NPI 1073014114
Dermatology in Fairview, TX

Active since February 23, 2018CLIA 45D2173789 · Microscopy
331 TOWN PL, FAIRVIEW, TX 75069(972) 747-0000(972) 736-4020 Get Directions Write a Review

NPPES record last updated: November 5, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 5, 2024, Jun 15, 2023, Feb 23, 2018 (3 updates tracked since 2018).

About Fairview Dermatology Pllc NPPES

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

FAIRVIEW DERMATOLOGY PLLC (NPI 1073014114) is a healthcare organization registered as a dermatology in Fairview, Texas and active in the NPI registry since February 2018. The organization holds a CLIA Microscopy certificate valid through October 17, 2027 and lists Andrew Hudson, Physician, as its authorized official.

NPPES Registry Identity

NPI1073014114
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameFAIRVIEW DERMATOLOGY PLLC
Location Address331 TOWN PLFairview, TX 75069-1825
Mailing Address331 Town PlFairview, TX 75069-1825 · (972) 747-0000 · Fax (972) 736-4020
Phone(972) 747-0000
Fax(972) 736-4020
Organization SubpartNo
Authorized OfficialAndrew HudsonPhysician · (806) 570-5338
Enumeration DateFebruary 23, 2018
Last NPPES UpdateNovember 5, 20243 updates tracked since enumeration
NPPES CertifiedNovember 5, 2024
✔ NPI 1073014114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
331 TOWN PL, Fairview, TX 75069
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fairview Dermatology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Fairview Dermatology PLLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Andrew Hudson, MD
Dermatology
NPI 1700349941
331 TOWN PL
Fairview, TX 75069
(972) 747-0000
✔ PECOS✔ Accepts MedicareSame address
Helen Kim-James, M.D.
Dermatology
NPI 1588647747
331 TOWN PL
Fairview, TX 75069
(972) 747-0000
✔ PECOS✔ Accepts MedicareSame address
Kevelyn Rose, MD
Dermatology
NPI 1114556651
331 TOWN PL
Fairview, TX 75069
(972) 747-0000
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 for Provider-Performed Microscopy Procedures (PPMP) 45D2173789

Fairview Dermatology · Fairview, TX
Active · expires Oct 17, 2027
CLIA Number45D2173789
Laboratory TypePhysician Office
Certificate Effective DateOctober 18, 2025
Certificate Expiration DateOctober 17, 2027
Laboratory DirectorAndrew D. Hudson
Laboratory Phone(972) 747-0000
Laboratory LocationFairview Dermatology331 Town Place, Fairview, TX 75069
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Fairview Dermatology PLLC's NPI number?

The NPI number for Fairview Dermatology PLLC is 1073014114. It was assigned to this organization in the NPPES registry on February 23, 2018.

Where is Fairview Dermatology PLLC located?

Fairview Dermatology PLLC is located at 331 Town Pl, Fairview, TX 75069. The listed phone number is (972) 747-0000.

What is Fairview Dermatology PLLC's specialty?

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

Is Fairview Dermatology PLLC enrolled in Medicare?

Yes. Fairview Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fairview Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Fairview Dermatology PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Fairview Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D2173789) is associated with this NPI, valid through October 17, 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 Fairview Dermatology PLLC was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.