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FORT WORTH DERMATOLOGY ASSOCIATES P A
NPI 1477668747
Dermatology - MOHS-Micrographic Surgery in Fort Worth, TX

Active since August 20, 2006CLIA 45D0988160 · Certificate of Compliance
1200 W ROSEDALE ST, FORT WORTH, TX 76104(817) 336-8131 Get Directions Write a Review

NPPES record last updated: February 9, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fort Worth Dermatology Associates P A NPPES

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

FORT WORTH DERMATOLOGY ASSOCIATES P A (NPI 1477668747) is a healthcare organization registered as a mohs-micrographic surgery in Fort Worth, Texas and active in the NPI registry since August 2006. The organization holds a CLIA Certificate of Compliance certificate valid through November 6, 2027 and lists James Douglas Maberry, Owner, as its authorized official.

NPPES Registry Identity

NPI1477668747
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameFORT WORTH DERMATOLOGY ASSOCIATES P A
Location Address1200 W ROSEDALE STFort Worth, TX 76104-4454
Mailing Address1200 W Rosedale StFort Worth, TX 76104-4454 · (817) 336-8131
Phone(817) 336-8131
Organization SubpartNo
Authorized OfficialJames Douglas MaberryOwner · (817) 336-8131
Enumeration DateAugust 20, 2006
Last NPPES UpdateFebruary 9, 2010
✔ NPI 1477668747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in TX · C8359
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
1200 W ROSEDALE ST, Fort Worth, TX 76104
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Other Identifiers 5

Medicare PINCC8286TX
Medicare PIN00U62U
Medicare UPIN00U62UTX
Medicare PIN070009295TX
Medicare PIN070009011TX

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

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 45D0988160

Fort Worth Dermatology Associates · Fort Worth, TX
Active · expires Nov 6, 2027
CLIA Number45D0988160
Laboratory TypePhysician Office
Certificate Effective DateNovember 7, 2025
Certificate Expiration DateNovember 6, 2027
Laboratory DirectorStephen D. Maberry
Laboratory Phone(817) 336-8131
Laboratory LocationFort Worth Dermatology Associates4828 Bryant Irvin Cort Ste 200, Fort Worth, TX 76107
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

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

DR. STEPHEN D MABERRY MD
Dermatology (MOHS-Micrographic Surgery)
1200 W ROSEDALE ST
FORT WORTH, TX 76104
Tarrant County (817) 336-8131

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 Fort Worth Dermatology Associates P A's NPI number?

The NPI number for Fort Worth Dermatology Associates P A is 1477668747. It was assigned to this organization in the NPPES registry on August 20, 2006.

Where is Fort Worth Dermatology Associates P A located?

Fort Worth Dermatology Associates P A is located at 1200 W Rosedale St, Fort Worth, TX 76104. The listed phone number is (817) 336-8131.

What is Fort Worth Dermatology Associates P A's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Fort Worth Dermatology Associates P A hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 45D0988160) is associated with this NPI, valid through November 6, 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 Fort Worth Dermatology Associates P A was last updated on February 9, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.