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General NPI Number Information
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NPI Number | 1649800848
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Entity Type | Organization
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Legal Business Name | SKIN CANCER DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 7979 BROADWAY STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2657
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Country | US
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Telephone | 210-601-6502
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Fax | 210-908-9666
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Provider Business Mailing Address
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Address Line | 7979 BROADWAY STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2657
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Country | US
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Telephone | 210-601-6502
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Fax | 210-908-9666
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | CALVIN L DAY
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Credential | MD
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Telephone | 210-601-6502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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