SOUTHEAST DERMATOLOGY, P.A.
NPI 1811932205
Dermatology in Pasadena, TX

Q: What is Southeast Dermatology, P.A.'s NPI number?

The NPI number for Southeast Dermatology, P.A. is 1811932205. It was assigned to this organization in the NPPES registry on June 18, 2006.

Q: What is Southeast Dermatology, P.A.'s specialty?

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

Active since June 18, 2006CLIA Certified · 2 labs

4419 CRENSHAW RD, PASADENA, TX 77504(281) 991-5944(281) 991-6849 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 21, 2026, Jun 10, 2022, Jun 13, 2016 (3 updates tracked since 2016).

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About Southeast Dermatology, P.a. NPPES

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

SOUTHEAST DERMATOLOGY, P.A. (NPI 1811932205) is a healthcare organization registered as a dermatology in Pasadena, Texas and active in the NPI registry since June 2006. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Houston, and lists Ashkan John Ghorbani, President, as its authorized official.

NPPES Registry Identity

NPI1811932205

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameSOUTHEAST DERMATOLOGY, P.A.

Location Address4419 CRENSHAW RDPasadena, TX 77504-3628

Mailing Address4419 Crenshaw RdPasadena, TX 77504-3628 · (281) 991-5944 · Fax (281) 991-6849

Phone(281) 991-5944

Fax(281) 991-6849

Organization SubpartNo

Authorized OfficialAshkan John GhorbaniPresident · (281) 991-5944

Enumeration DateJune 18, 2006

Last NPPES UpdateApril 21, 20263 updates tracked since enumeration

NPPES CertifiedApril 21, 2026

✔ NPI 1811932205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

4419 CRENSHAW RD, Pasadena, TX 77504

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Secondary Practice Location 1

Location 111914 Astoria Blvd Ste 570Houston, TX 77089-6079 · Phone (281) 481-0033

Other Identifiers 1

Medicaid080342101TX

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 45D0944605

Southeast Dermatology, PA · Pasadena, TX

Active · expires Apr 14, 2028

CLIA Number45D0944605

Laboratory TypePhysician Office

Certificate Effective DateApril 15, 2026

Certificate Expiration DateApril 14, 2028

Laboratory DirectorMatthew S. Petitt

Laboratory Phone(281) 481-0033

Laboratory LocationSoutheast Dermatology, PA4419 Crenshaw Road, Pasadena, TX 77504

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 45D0686649

Southeast Dermatology, PA · Houston, TX

Active · expires Jan 12, 2028

CLIA Number45D0686649

Laboratory TypePhysician Office

Certificate Effective DateJanuary 13, 2026

Certificate Expiration DateJanuary 12, 2028

Laboratory DirectorMatthew S. Petitt

Laboratory Phone(281) 481-0033

Laboratory LocationSoutheast Dermatology, PA11914 Astoria Blvd Suite 570, Houston, TX 77089

CLIA data matches this NPI record on: Address 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 11

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

ELIZABETH KAYE PETITT FNP

Nurse Practitioner (Family)