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General NPI Number Information
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NPI Number | 1750906319
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Entity Type | Organization
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Legal Business Name | DALLAS DERMATOLOGY AND AESTHETICS, PLLC
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 4104 W 15TH ST STE 202
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City | PLANO
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State | TX
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Zip | 75093-5860
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Country | US
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Telephone | 972-608-3100
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Fax | 972-608-3101
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Provider Business Mailing Address
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Address Line | 4104 W 15TH ST STE 202
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City | PLANO
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State | TX
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Zip | 75093-5860
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Country | US
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Telephone | 972-608-3100
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Fax | 972-608-3101
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Authorized Official
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Title or Position | MANAGING PARTNER, DERMATOLOGIST
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Name | DR. ASHWIN AGARWAL
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Credential | MD
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Telephone | 972-608-3100
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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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