Prestige Dermatology of Alliance, PLLC
NPI 1427415314ActiveOrganization· Dermatology· Fort Worth, TX
Dermatology in Fort Worth, Texas, registered in NPPES in January 2016. The authorized official on file is Ryan Pham, D.O, Managing Member. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1427415314 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 22, 2016 |
| Last updated in NPPES | Jan 21, 2021 |
| Certified by provider | Jan 21, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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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