MEDICARE: J ROBERT WEST, M.D., INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207ND0101X	MOHS-Micrographic Surgery Physician
2	207NS0135X	Procedural Dermatology Physician
3	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1295338416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J ROBERT WEST, M.D., INC

Provider Business Mailing Address
First Line	:	9900 N CENTRAL EXPY STE 500
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0928
Country	:	US
Telephone Number	:	214-987-3376
Fax Number	:	469-532-0273

Provider Business Practice Location Address
First Line	:	630 S RANCHO DR STE E
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4849
Country	:	US
Telephone Number	:	702-258-1001
Fax Number	:	702-258-8215

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	KARA LYNN FOLEY
Credential	:
Telephone Number	:	702-360-2763

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	05/12/2026

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