Healthcare Provider Details

I. General information

NPI: 1235644972
Provider Name (Legal Business Name): TRUE DERMATOLOGY DFW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 01/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 WATTERS CREEK BLVD
ALLEN TX
75013-3734
US

IV. Provider business mailing address

6170 RESEARCH RD STE 109
FRISCO TX
75033-3508
US

V. Phone/Fax

Practice location:
  • Phone: 972-635-3400
  • Fax:
Mailing address:
  • Phone: 972-635-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRYAN LOWERY
Title or Position: OWNER
Credential: MD
Phone: 972-635-3402