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General NPI Number Information
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NPI Number | 1457803421
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY CENTER, LLC
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 111 VETERANS BLVD SUITE 406A
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City | METAIRIE
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State | LA
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Zip | 70005-3028
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Country | US
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Telephone | 504-336-2400
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Fax | 504-437-1634
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Provider Business Mailing Address
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Address Line | 1620 W NORTHWEST HWY SUITE #100
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City | GRAPEVINE
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State | TX
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Zip | 76051-3177
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Country | US
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Telephone | 817-572-0009
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Fax | 817-572-0221
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Authorized Official
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Title or Position | CEO
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Name | BILL BUTLER
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Credential |
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Telephone | 615-416-3270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY.007385
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License Number State | LA
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