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General NPI Number Information
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NPI Number | 1740636349
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Entity Type | Organization
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Legal Business Name | PRECISION DERMATOLOGY PA
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 712 HILL COUNTRY DR STE 100
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City | KERRVILLE
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State | TX
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Zip | 78028-6166
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Country | US
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Telephone | 830-890-5181
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Fax | 830-590-5162
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Provider Business Mailing Address
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Address Line | PO BOX 1416
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City | SAN ANTONIO
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State | TX
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Zip | 78295-1416
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Country | US
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Telephone | 830-890-5181
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Fax | 830-890-5162
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW LAMBIASE
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Credential | MD
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Telephone | 830-890-5181
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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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