WESTLAKE DERMATOLOGY
NPI 1659401024
Dermatology in Austin, TX

Active since March 06, 2007CLIA Certified · 2 labs
12201 RENFERT WAY, SUITE 305, AUSTIN, TX 78758(512) 279-3376(512) 306-0222 Get Directions Write a Review

NPPES record last updated: May 22, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Westlake Dermatology NPPES

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

WESTLAKE DERMATOLOGY (NPI 1659401024) is a healthcare organization registered as a dermatology in Austin, Texas and active in the NPI registry since March 2007. The organization holds 2 active CLIA laboratory certificates and lists Gregory A Nikolaidis, President, as its authorized official.

NPPES Registry Identity

NPI1659401024
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWESTLAKE DERMATOLOGY PA
Location Address12201 RENFERT WAY, SUITE 305Austin, TX 78758-5354
Mailing Address6836 Bee Cave Rd, Suite 111Austin, TX 78746-5059 · (512) 279-3376 · Fax (512) 306-0222
Fax(512) 306-0222
Organization SubpartNo
Authorized OfficialGregory A NikolaidisPresident · (512) 328-3376
Enumeration DateMarch 6, 2007
Last NPPES UpdateMay 22, 2008
NPI 1659401024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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 · DermatopathologyTaxonomy 207ND0900X
12201 RENFERT WAY, Austin, TX 78758

Other Names 1

Doing Business AsWestlake Dermatology

Other Identifiers 2

Other00591TTX · Bcbs Grp#
Medicare PIN00591TTX

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

CLIA Laboratory Certificates CMS CLIA 2

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 45D2300893

Westlake Dermatology - Georgetown · Georgetown, TX
Active · expires Nov 18, 2026
CLIA Number45D2300893
Laboratory TypePhysician Office
Certificate Effective DateNovember 19, 2024
Certificate Expiration DateNovember 18, 2026
Laboratory DirectorAdam J. Mamelak
Laboratory Phone(512) 279-3376
Laboratory LocationWestlake Dermatology - Georgetown4235 Williams Drive, Georgetown, TX 78628
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.

Certificate of Waiver 45D2257733

Westlake Dermatology - Domain Northside · Austin, TX
Active · expires Apr 10, 2028
CLIA Number45D2257733
Laboratory TypePhysician Office
Certificate Effective DateApril 11, 2026
Certificate Expiration DateApril 10, 2028
Laboratory DirectorGregory Nikolaidis
Laboratory Phone(512) 649-1004
Laboratory LocationWestlake Dermatology - Domain Northside11801 Domain Blvd, Ste 120, Austin, TX 78758
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.

Orthopaedic Surgery
12201 RENFERT WAY, SUITE 370
AUSTIN, TX 78758
Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
12201 RENFERT WAY, SUITE 115
AUSTIN, TX 78758
Surgery (Surgical Oncology)
12201 RENFERT WAY, SUITE 240
AUSTIN, TX 78758
Specialist
12201 RENFERT WAY, STE 340
AUSTIN, TX 78758
Specialist
12201 RENFERT WAY, SUITE 230
AUSTIN, TX 78758
Ophthalmology
12201 RENFERT WAY, SUITE 100
AUSTIN, TX 78758
Nurse Practitioner (Women's Health)
12201 RENFERT WAY, STE. 225
AUSTIN, TX 78758
Orthopaedic Surgery (Orthopaedic Trauma)
12201 RENFERT WAY, SUITE 115
AUSTIN, TX 78758

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 Westlake Dermatology PA's NPI number?

The NPI number for Westlake Dermatology PA is 1659401024. It was assigned to this organization in the NPPES registry on March 6, 2007. The provider is doing business as Westlake Dermatology.

Where is Westlake Dermatology PA located?

Westlake Dermatology PA is located at 12201 Renfert Way Suite 305, Austin, TX 78758. The listed phone number is (512) 279-3376.

What is Westlake Dermatology PA's specialty?

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

Does Westlake Dermatology PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Westlake Dermatology PA was last updated on May 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.