Provider Demographics
NPI:1528829025
Name:UNITED DERMATOLOGY ASSOCIATES OF EULESS PLLC
Entity type:Organization
Organization Name:UNITED DERMATOLOGY ASSOCIATES OF EULESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-261-1122
Mailing Address - Street 1:723 N FIELDER RD STE C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4662
Mailing Address - Country:US
Mailing Address - Phone:817-261-1122
Mailing Address - Fax:817-207-4189
Practice Address - Street 1:2101 WESTPARK CT STE 150
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3717
Practice Address - Country:US
Practice Address - Phone:817-261-1122
Practice Address - Fax:817-207-4189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty