DERMATOLOGY SURGERY CENTER
NPI 1700822335
Clinic/Center - Ambulatory Surgical in Tyler, TX

Q: What is Oliver Street Dermatology ASC LLC's NPI number?

The NPI number for Oliver Street Dermatology ASC LLC is 1700822335. It was assigned to this organization in the NPPES registry on June 21, 2006. The provider is doing business as Dermatology Surgery Center.

Q: What is Oliver Street Dermatology ASC LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since June 21, 2006CLIA 45D1011220 · Accreditation

1367 DOMINION PLAZA, TYLER, TX 75703(903) 534-6200(903) 939-0755 Get Directions Write a Review

NPPES record last updated: February 6, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dermatology Surgery Center NPPES

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

DERMATOLOGY SURGERY CENTER (NPI 1700822335) is a healthcare organization registered as an ambulatory surgical in Tyler, Texas and active in the NPI registry since June 2006. The organization holds an CLIA Accreditation certificate valid through January 1, 2027 and lists Andrea Lynne Stein, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1700822335

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameOLIVER STREET DERMATOLOGY ASC LLC

Location Address1367 DOMINION PLAZATyler, TX 75703-1013

Mailing Address1367 Dominion PlazaTyler, TX 75703-1013 · (903) 534-6200 · Fax (903) 939-0755

Phone(903) 534-6200

Fax(903) 939-0755

Organization SubpartNo

Authorized OfficialAndrea Lynne SteinPractice Administrator · (903) 534-6200

Enumeration DateJune 21, 2006

Last NPPES UpdateFebruary 6, 2013

✔ NPI 1700822335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in TX · 007937

1367 DOMINION PLAZA, Tyler, TX 75703

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Other Names 1

Doing Business AsDermatology Surgery Center

Other Identifiers 3

OtherP00044713TX · Railroad Medicare Ptan

Medicaid162384501TX

Medicare PINASC177TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

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 Accreditation 45D1011220

Oliver Street Dermatology ASC LLC Dba Dermatology Surgery Center · Tyler, TX

Active · expires Jan 1, 2027

CLIA Number45D1011220

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJanuary 2, 2025

Certificate Expiration DateJanuary 1, 2027

Laboratory DirectorDr. Jennifer Holman

Laboratory Phone(903) 534-6200

Laboratory LocationOliver Street Dermatology ASC LLC Dba Dermatology Surgery Center1367 Dominion Plaza, Tyler, TX 75703

CLIA data matches this NPI record on: Address Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm 13132

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

620 services585 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

269 services260 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm 14041

This procedure involves repairing a wound on specified body areas by transferring skin from another part of the body. The transferred skin, measuring between 10.1 to 30.0 square cm, aids in healing the wound and restoring the skin's normal function.

95 services92 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm 13152

This procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.

89 services89 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm 13121

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

84 services83 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm 14061

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by transferring skin from another part of the body. The size of the skin transferred will be between 10.1 to 30.0 square centimeters. It is performed to restore function and appearance.

84 services84 patients

Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm 14021

This procedure involves repairing a wound on your scalp, arm, or leg by moving skin from another part of your body. The skin transferred will cover an area between 10.1 to 30.0 square cm. This helps promote healing and reduce scarring.

70 services68 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less 14040

This procedure involves repairing a wound on various body parts by transferring skin from another area. The transferred skin, up to 10.0 sq cm, helps to cover the wound, promoting healing and reducing scarring. It's a common method for treating larger or deeper wounds.

63 services63 patients

Repair of wound by transferring skin, 30.1-60.0 sq cm 14301

This procedure involves repairing a wound by moving healthy skin from one area of the body to the wound site. The transferred skin, measuring between 30.1-60.0 square cm, aids in healing and reduces scarring.

61 services60 patients

Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm 13151

This procedure involves the intricate repair of a wound that is 1.1 to 2.5 cm long on your eyelids, nose, ears, or lip. The goal is to mend the wound carefully to preserve function and minimize scarring. The process may involve stitching and other techniques.

49 services49 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm 13131

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size is between 1.1-2.5 cm. This repair may involve multiple layers of sutures and could require reconstruction of the skin.

44 services44 patients

Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less 14020

This procedure involves repairing a wound on your scalp, arm, or leg by transferring a small piece of skin, 10.0 sq cm or less, from a different area of your body. This skin graft helps promote healing and minimizes scarring.

16 services16 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

15 services15 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm 12042

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

15 services15 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

13 services13 patients

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less 15260

A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.

11 services11 patients

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Other Providers at the Same Location NPPES 5

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

BRADLEY SCOTT GRAHAM MD

Dermatology