MEDICARE: ON SITE DERMATOLOGY OF TEXAS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1568808459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON SITE DERMATOLOGY OF TEXAS PLLC

Provider Business Mailing Address
First Line	:	4700 EXCHANGE CT STE 110
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-4450
Country	:	US
Telephone Number	:	561-314-2000
Fax Number	:	561-989-3665

Provider Business Practice Location Address
First Line	:	1103 CYPRESS CREEK RD STE 100
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-3925
Country	:	US
Telephone Number	:	877-345-5300
Fax Number	:	561-989-3665

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ANIMESH SINHA
Credential	:	MD
Telephone Number	:	561-314-2000

Provider Enumeration Date	:	05/17/2013
Last Update Date	:	06/30/2025

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