Healthcare Provider Details

I. General information

NPI: 1588292841
Provider Name (Legal Business Name): CORLEY CATHERINE DEES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORLEY CATHERINE PRUNEDA MD

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 HARBORSIDE DR 5TH FLOOR
GALVESTON TX
77555-4917
US

IV. Provider business mailing address

3605 EXECUTIVE DR
SAN ANGELO TX
76904-6884
US

V. Phone/Fax

Practice location:
  • Phone: 409-747-3376
  • Fax:
Mailing address:
  • Phone: 325-747-2215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberU3626
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberU3626
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: