Provider Demographics
NPI:1861209298
Name:ELITE DERM SERVICES, PLLC
Entity type:Organization
Organization Name:ELITE DERM SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-612-0050
Mailing Address - Street 1:27131 FULSHEAR BEND DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1231
Mailing Address - Country:US
Mailing Address - Phone:281-612-0050
Mailing Address - Fax:281-612-0051
Practice Address - Street 1:27131 FULSHEAR BEND DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1231
Practice Address - Country:US
Practice Address - Phone:281-612-0050
Practice Address - Fax:281-612-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty