MEDICARE: TOTAL DERMATOLOGY BELLAIRE, PLLC

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	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1750232583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL DERMATOLOGY BELLAIRE, PLLC

Provider Business Mailing Address
First Line	:	4811 MAPLE ST
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-5728
Country	:	US
Telephone Number	:	713-305-6600
Fax Number	:	832-975-8425

Provider Business Practice Location Address
First Line	:	6565 WEST LOOP S STE 800
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-3505
Country	:	US
Telephone Number	:	713-661-4383
Fax Number	:	832-975-8425

Authorized Official
Title or Position	:	MD
Name	:	CRAIG FOREST TELLER
Credential	:	MD
Telephone Number	:	713-305-6600

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/19/2026

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