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MAGNOLIA DERMATOLOGY
NPI 1235890807
Dermatology in Cypress, TX

Active since January 06, 2022CLIA 45D2262443 · Microscopy
10547 FRY ROAD, CYPRESS, TX 77433(832) 834-3349(832) 281-0218 Get Directions Write a Review

NPPES record last updated: May 8, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 8, 2023, Jul 10, 2022, Jan 6, 2022 (3 updates tracked since 2022).

About Magnolia Dermatology NPPES

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

MAGNOLIA DERMATOLOGY (NPI 1235890807) is a healthcare organization registered as a dermatology in Cypress, Texas and active in the NPI registry since January 2022. The organization holds a CLIA Microscopy certificate valid through June 13, 2028 and lists Samantha Jane Robare, Owner, as its authorized official.

NPPES Registry Identity

NPI1235890807
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMAGNOLIA DERMATOLOGY
Location Address10547 FRY ROADCypress, TX 77433
Mailing Address10547 Fry RoadCypress, TX 77433 · (832) 834-3349 · Fax (832) 281-0218
Phone(832) 834-3349
Fax(832) 281-0218
Organization SubpartNo
Authorized OfficialSamantha Jane RobareOwner · (832) 834-3349
Enumeration DateJanuary 6, 2022
Last NPPES UpdateMay 8, 20233 updates tracked since enumeration
NPPES CertifiedMay 8, 2023
✔ NPI 1235890807 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.
10547 FRY ROAD, Cypress, TX 77433
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Other Names 1

Doing Business AsMagnolia Dermatology

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)

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

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Magnolia Dermatology, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Samantha Robare, MD
Dermatology
NPI 1306161211
10547 FRY RD
Cypress, TX 77433
(832) 834-3349
✔ PECOS✔ Accepts MedicareSame address
Vannica Soy, FNP-C
Nurse Practitioner
NPI 1245843473
27150 HIGHWAY 290 STE 100
Cypress, TX 77433
(832) 653-3300
✔ PECOS✔ Accepts Medicare5.5 mi

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) 45D2262443

Magnolia Dermatology · Cypress, TX
Active · expires Jun 13, 2028
CLIA Number45D2262443
Laboratory TypePhysician Office
Certificate Effective DateJune 14, 2026
Certificate Expiration DateJune 13, 2028
Laboratory DirectorSamantha J. Robare
Laboratory Phone(832) 834-3349
Laboratory LocationMagnolia Dermatology10547 Fry Road, Cypress, TX 77433
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 Magnolia Dermatology's NPI number?

The NPI number for Magnolia Dermatology is 1235890807. It was assigned to this organization in the NPPES registry on January 6, 2022.

Where is Magnolia Dermatology located?

Magnolia Dermatology is located at 10547 Fry Road, Cypress, TX 77433. The listed phone number is (832) 834-3349.

What is Magnolia Dermatology's specialty?

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

Is Magnolia Dermatology enrolled in Medicare?

Yes. Magnolia Dermatology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Magnolia Dermatology?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Magnolia Dermatology, in Dermatology and Nurse Practitioner. 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, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Magnolia Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D2262443) is associated with this NPI, valid through June 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Magnolia Dermatology was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.