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General NPI Number Information
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NPI Number | 1235644972
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Entity Type | Organization
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Legal Business Name | TRUE DERMATOLOGY DFW, PLLC
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 918 WATTERS CREEK BLVD
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City | ALLEN
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State | TX
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Zip | 75013-3734
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Country | US
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Telephone | 972-635-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 6170 RESEARCH RD STE 109
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City | FRISCO
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State | TX
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Zip | 75033-3508
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Country | US
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Telephone | 972-635-3401
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN LOWERY
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Credential | MD
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Telephone | 972-635-3402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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