MOUNTAIN WEST DERM - BLACKHART PLLC
NPI 1366018848
Dermatology in Georgetown, TX

Q: What is Mountain West Derm - Blackhart PLLC's NPI number?

The NPI number for Mountain West Derm - Blackhart PLLC is 1366018848. It was assigned to this organization in the NPPES registry on June 3, 2021. The provider is doing business as Vitalogy Skincare.

Q: What is Mountain West Derm - Blackhart PLLC's specialty?

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

Active since June 03, 2021

4513 WILLIAMS DR, GEORGETOWN, TX 78633(512) 930-3909(512) 240-5469 Get Directions Write a Review

NPPES record last updated: June 14, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 14, 2021, Jun 3, 2021 (2 updates tracked since 2021).

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About Mountain West Derm - Blackhart Pllc NPPES

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

MOUNTAIN WEST DERM - BLACKHART PLLC (NPI 1366018848), doing business as Vitalogy Skincare, is a healthcare organization registered as a dermatology in Georgetown, Texas and active in the NPI registry since June 2021. The organization lists Bret S Blackhart, President, as its authorized official.

NPPES Registry Identity

NPI1366018848

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameMOUNTAIN WEST DERM - BLACKHART PLLC

Location Address4513 WILLIAMS DRGeorgetown, TX 78633-1302

Mailing Address4513 Williams DrGeorgetown, TX 78633-1302 · (512) 763-3803 · Fax (512) 240-5469

Phone(512) 930-3909

Fax(512) 240-5469

Organization SubpartNo

Authorized OfficialBret S BlackhartPresident · (775) 336-3624

Enumeration DateJune 3, 2021

Last NPPES UpdateJune 14, 20212 updates tracked since enumeration

NPPES CertifiedJune 14, 2021

✔ NPI 1366018848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X

4513 WILLIAMS DR, Georgetown, TX 78633

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Other Names 1

Doing Business AsVitalogy Skincare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 ›

Other Providers at the Same Location NPPES 11

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

VITALOGY P.A.

Dermatology