Epiphany Dermatology PA

NPI #1043615263 in Waco, Texas

Provider Information

NPI Number: 1043615263
Entity Type: Organization
Organization Name: Epiphany Dermatology PA
Primary Specialty: Dermatology
Enumeration Date: Oct 30, 2014
Last Updated: Jul 21, 2023

Practice Location

Address: 7106 SANGER AVENUE
City: Waco
State: Texas
ZIP Code: 76712-3928
Phone: (254) 537-1265

Authorized Official

Name: MR. GHEORGHE PUSTA
Title: CEO
Phone: (512) 628-0465

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery	207ND0101X
Clinic/Center - Radiology — Radiology	261QR0200X
Dermatology	207N00000X	Primary

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