BRAZOSPORT DERMATOLOGY CLINIC PA
NPI 1457465452
Dermatology in Lake Jackson, TX

Active since August 18, 2006
BRAZOSPORT DERMATOLOGY CLINIC PA, 215 OAK DRIVE SOUTH STE C, LAKE JACKSON, TX 77566(979) 297-6458(979) 297-0076 Get Directions Write a Review

NPPES record last updated: December 30, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Brazosport Dermatology Clinic Pa NPPES

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

BRAZOSPORT DERMATOLOGY CLINIC PA (NPI 1457465452) is a healthcare organization registered as a dermatology in Lake Jackson, Texas and active in the NPI registry since August 2006. The organization lists Frank A Peltier, President, as its authorized official.

NPPES Registry Identity

NPI1457465452
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBRAZOSPORT DERMATOLOGY CLINIC PA
Location AddressBRAZOSPORT DERMATOLOGY CLINIC PA, 215 OAK DRIVE SOUTH STE CLake Jackson, TX 77566
Mailing Address215 Oak Dr S, Ste CLake Jackson, TX 77566-5617 · (979) 297-6458 · Fax (979) 297-0076
Fax(979) 297-0076
Organization SubpartNo
Authorized OfficialFrank A PeltierPresident · (979) 297-6458
Enumeration DateAugust 18, 2006
Last NPPES UpdateDecember 30, 2010
NPI 1457465452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in TX · F1894
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.
BRAZOSPORT DERMATOLOGY CLINIC PA, Lake Jackson, TX 77566

Other Identifiers 3

Medicare ID-Type Unspecified8E0068TX
Medicaid035781601TX
Medicare UPINB25455

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

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 Brazosport Dermatology Clinic PA's NPI number?

The NPI number for Brazosport Dermatology Clinic PA is 1457465452. It was assigned to this organization in the NPPES registry on August 18, 2006.

Where is Brazosport Dermatology Clinic PA located?

Brazosport Dermatology Clinic PA is located at Brazosport Dermatology Clinic PA 215 Oak Drive South Ste C, Lake Jackson, TX 77566. The listed phone number is (979) 297-6458.

What is Brazosport Dermatology Clinic PA's specialty?

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

When was this NPI record last updated?

The NPPES record for Brazosport Dermatology Clinic PA was last updated on December 30, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.