MEDICARE: HOLISTIC DERMATOLOGY OF HOUSTON, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	P0022	TX

General Provider Information

NPI Number	:	1013468396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC DERMATOLOGY OF HOUSTON, PA

Provider Business Mailing Address
First Line	:	2030 N LOOP FWY W
Second Line	:	SUITE 120
City	:	HOUSTON
State	:	TX
Zip	:	77018-8101
Country	:	US
Telephone Number	:	832-639-3376
Fax Number	:	888-824-9953

Provider Business Practice Location Address
First Line	:	2030 N LOOP FWY W
Second Line	:	SUITE 120
City	:	HOUSTON
State	:	TX
Zip	:	77018-8101
Country	:	US
Telephone Number	:	832-639-3376
Fax Number	:	888-824-9953

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	DR. KAREN CHEN
Credential	:	M.D.
Telephone Number	:	713-898-1419

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	07/21/2022

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