Provider Demographics
NPI:1154013423
Name:SKIN HEALTH DERMATOLOGY, PLLC
Entity type:Organization
Organization Name:SKIN HEALTH DERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MD
Authorized Official - Phone:254-265-7546
Mailing Address - Street 1:611 W STATE HIGHWAY 6 STE 115
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7545
Mailing Address - Country:US
Mailing Address - Phone:254-265-7546
Mailing Address - Fax:
Practice Address - Street 1:611 W STATE HIGHWAY 6 STE 115
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7545
Practice Address - Country:US
Practice Address - Phone:254-265-7546
Practice Address - Fax:254-265-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty