| NPI | 1184410987 |
|---|---|
| Doing Business As | PRODERM SKIN & SURGERY |
| Entity Type | Organization |
| Authorized Contact | SYDNEY LARKIN PROFFER Sole Member 512-535-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-06-17 |