MEDICARE: FOREFRONT DERMATOLOGY - HOUSTON, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207NS0135X	Procedural Dermatology Physician
2	207ND0101X	MOHS-Micrographic Surgery Physician
3	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1619860715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREFRONT DERMATOLOGY - HOUSTON, PLLC

Provider Business Mailing Address
First Line	:	801 YORK ST
Second Line	:
City	:	MANITOWOC
State	:	WI
Zip	:	54220-4630
Country	:	US
Telephone Number	:	920-663-9008
Fax Number	:	920-684-1439

Provider Business Practice Location Address
First Line	:	1235 LAKE POINTE PKWY STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4077
Country	:	US
Telephone Number	:	281-665-4444
Fax Number	:	281-980-0177

Authorized Official
Title or Position	:	DELEGATED OFFICIAL
Name	:	DENISE ANGER
Credential	:
Telephone Number	:	920-663-9022

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	06/03/2026

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