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General NPI Number Information
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NPI Number | 1447283890
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY OF THE SOUTHWEST PA
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7777 SOUTHWEST FWY SUITE 956
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City | HOUSTON
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State | TX
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Zip | 77074-1802
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Country | US
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Telephone | 713-772-7202
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Fax | 713-772-7290
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Provider Business Mailing Address
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Address Line | 7777 SOUTHWEST FWY SUITE 956
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City | HOUSTON
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State | TX
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Zip | 77074-1802
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Country | US
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Telephone | 713-772-7202
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Fax | 713-772-7290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NORMAN D. GUZICK
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Credential | M.D.
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Telephone | 713-772-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | D9471
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License Number State | TX
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