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General NPI Number Information
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NPI Number | 1316072929
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Entity Type | Organization
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Legal Business Name | BAY AREA LASER SKIN CARE AND WELLNESS CENTER
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1203 WEST BAY AREA BLVD.
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City | HOUSTON
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State | TX
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Zip | 77598
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Country | US
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Telephone | 832-868-9313
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Fax | 832-422-9393
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Provider Business Mailing Address
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Address Line | 2925-B GULF FREEWAY SOUTH #386
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City | LEAGUE CITY
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State | TX
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Zip | 77573
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Country | US
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Telephone | 832-868-9313
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Fax | 832-422-9393
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | DR. ERIC ROBERSON
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Credential | MD
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Telephone | 832-868-9313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K2109
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L6264
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA01230
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L6264
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License Number State | TX
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