TEXOMA DERMATOLOGY CLINIC, P.A.
NPI 1720003288
Specialist in Sherman, TX
NPI Status: Active since July 13, 2006
Contact Information
815 PECAN GROVE RD E
SHERMAN, TX
ZIP 75090
Phone: (903) 892-2126
Fax: (903) 892-2129
- Organization
- Specialist
- CLIA Number: 45D2134912
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-09-2025
About TEXOMA DERMATOLOGY CLINIC, P.A.
This page provides the complete NPI Profile along with additional information for Texoma Dermatology Clinic, P.a., a provider established in Sherman, Texas operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1720003288 assigned on July 2006. The practitioner's primary taxonomy code is 174400000X with license number L3843 (TX). The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Johhny Creed Stewart M.d. (President)
- NPI
- 1720003288
- Provider Name
- TEXOMA DERMATOLOGY CLINIC, P.A.
- Entity Type
- Organization
- Location Address
- 815 PECAN GROVE RD E SHERMAN, TX 75090
- Location Phone
- (903) 892-2126
- Location Fax
- (903) 892-2129
- Mailing Address
- 815 PECAN GROVE RD E SHERMAN, TX 75090
- Mailing Phone
- (903) 892-2126
- Mailing Fax
- (903) 892-2129
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-13-2006
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- L3843
- License State
- TX
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2134912
- Facility Type
- Physician Office
- Certificate Effective Date
- August 10, 2023
- Certificate Expiration Date
- August 09, 2025
- Laboratory Director
- CLINT C. MOSS
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Texoma Dermatology Clinic, P.a. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 2 | 0 | 0 | 0 | 3 | 2 | 8 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 4 | 0 | 0 | 0 | 6 | 2 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 4 + 0 + 0 + 0 + 6 + 2 + 1 + 6 + 24 = 52 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 52 = 8 | 8 | ||||||||
The NPI number 1720003288 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
JOHNNY CREED STEWART MD
Dermatology
815 PECAN GROVE RD E
SHERMAN, TX
ZIP 75090
CLINT CAMERON MOSS MD
Dermatology
815 PECAN GROVE RD E
SHERMAN, TX
ZIP 75090
MR. KENNETH LLOYD SPENCER JR. PA
Physician Assistant
(Medical)
815 PECAN GROVE RD E
SHERMAN, TX
ZIP 75090
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720003288, enumerated as an "organization" on July 13, 2006.
The provider is located at 815 PECAN GROVE RD E SHERMAN, TX 75090 and the phone number is (903) 892-2126.
Specialist with taxonomy code 174400000X.
