NPI | 1154598779 |
---|---|
Doing Business As | WESTLAKE DERMATOLOGY |
Entity Type | Organization |
Authorized Contact | GREGORY A NIKOLAIDIS President 512-328-3376 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2008-05-13 |
Last Update Date | 2015-11-05 |