| NPI | 1902452360 |
|---|---|
| Doing Business As | ELITE DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | TIFFANY AUTRY Officer 409-719-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2023-01-21 |