MEDICARE: SKIN BAR HTX

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	174400000X	Specialist
3	171400000X	Health & Wellness Coach
4	207NS0135X	Procedural Dermatology Physician
5	208600000X	Surgery Physician
6	208D00000X	General Practice Physician
7	2251E1300X	Clinical Electrophysiology Physical Therapist
8	261QP2300X	Primary Care Clinic/Center
9	363L00000X	Nurse Practitioner
10	163WG0000X	General Practice Registered Nurse
11	163WS0121X	Plastic Surgery Registered Nurse
12	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1265015309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKIN BAR HTX

Provider Business Mailing Address
First Line	:	2646 S LOOP W STE 240
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2676
Country	:	US
Telephone Number	:	346-284-6366
Fax Number	:

Provider Business Practice Location Address
First Line	:	2646 S LOOP W STE 240
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2676
Country	:	US
Telephone Number	:	346-284-6366
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHLEY K CARTER
Credential	:
Telephone Number	:	346-284-6366

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	01/24/2024

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Directions to “SKIN BAR HTX ” Practice Location

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