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CENTRAL TEXAS DERMATOLOGY, PA
NPI 1164566246
Specialist in West Lake Hills, TX

Active since February 20, 2007CLIA 45D0505556 · Certificate of Compliance
102 WESTLAKE DR, #100, WEST LAKE HILLS, TX 78746(512) 327-7779 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 4, 2019, Dec 11, 2018 (2 updates tracked since 2018).

About Central Texas Dermatology, Pa NPPES

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

CENTRAL TEXAS DERMATOLOGY, PA (NPI 1164566246) is a healthcare organization registered as a specialist in West Lake Hills, Texas and active in the NPI registry since February 2007. The organization holds a CLIA Certificate of Compliance certificate valid through July 14, 2027 and lists Debra Petrie, Biller/credentialer, as its authorized official.

NPPES Registry Identity

NPI1164566246
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameCENTRAL TEXAS DERMATOLOGY, PA
Location Address102 WESTLAKE DR, #100West Lake Hills, TX 78746
Mailing Address102 Westlake Dr, Ste 100West Lake Hills, TX 78746-5373 · (512) 327-7779
Phone(512) 327-7779
Organization SubpartNo
Authorized OfficialDebra PetrieBiller/credentialer · (512) 327-8449
Enumeration DateFebruary 20, 2007
Last NPPES UpdateSeptember 13, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2023
✔ NPI 1164566246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · F4405
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
102 WESTLAKE DR, West Lake Hills, TX 78746
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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 45D0505556

Central Texas Dermatology · Austin, TX
Active · expires Jul 14, 2027
CLIA Number45D0505556
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2025
Certificate Expiration DateJuly 14, 2027
Laboratory DirectorEmily Prosise
Laboratory Phone(512) 327-7779
Laboratory LocationCentral Texas Dermatology102 Westlake Drive # 100, Austin, TX 78746
CLIA data matches this NPI record on: Name 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 20

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

ENRIQUE R LOPEZ
Behavior Analyst
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272
WILLIAM MARSHALL RAMSDELL M.D.
Specialist
102 WESTLAKE DR, SUITE 100
WEST LAKE HILLS, TX 78746
Travis County (512) 327-7779
BRITTANY HENG BA
Behavior Technician
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272
JENNIFER N BUXTON
Behavior Technician
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272
KATHERINE ALECIA VASQUEZ
Behavior Technician
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272
TRACY STEPHANY MONTERROZA BCAT, RBT
Behavior Technician
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272
MICHELLE YEN-THY TRAN
Behavior Technician
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272
MASON NEAL
Behavior Technician
102 WESTLAKE DR
WEST LAKE HILLS, TX 78746
Travis County (512) 813-7272

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 Central Texas Dermatology, PA's NPI number?

The NPI number for Central Texas Dermatology, PA is 1164566246. It was assigned to this organization in the NPPES registry on February 20, 2007.

Where is Central Texas Dermatology, PA located?

Central Texas Dermatology, PA is located at 102 Westlake Dr #100, West Lake Hills, TX 78746. The listed phone number is (512) 327-7779.

What is Central Texas Dermatology, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Central Texas Dermatology, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D0505556) is associated with this NPI, valid through July 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Central Texas Dermatology, PA accept?

Health plans from Moda Health Plan, Inc. list Central Texas Dermatology, PA 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 Central Texas Dermatology, PA was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.