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General NPI Number Information
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NPI Number | 1831886787
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Entity Type | Organization
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Legal Business Name | LONE STAR DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 130 MEDICAL CENTER PKWY STE 3
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City | HUNTSVILLE
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State | TX
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Zip | 77340-4943
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Country | US
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Telephone | 936-295-1311
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Fax |
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Provider Business Mailing Address
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Address Line | 130 MEDICAL CENTER PKWY STE 3
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City | HUNTSVILLE
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State | TX
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Zip | 77340-4943
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Country | US
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Telephone | 936-295-1311
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. CHELSEA HARPER
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Credential | DO
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Telephone | 936-295-1311
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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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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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