Central Texas Dermatology, PA
NPI 1164566246ActiveOrganization· Specialist· West Lake Hills, TX
Specialist in West Lake Hills, Texas, registered in NPPES in February 2007. The authorized official on file is Debra Petrie, BILLER, Biller/Credentialer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164566246 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 20, 2007 |
| Last updated in NPPES | Sep 13, 2023 |
| Certified by provider | Sep 13, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | F4405 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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