NPI age
12 years
Enumerated 2014-05-22
● Active Type 2 · Organization
Lone Star State Dermatology Clinic Pllc
Lone Star State Dermatology Clinic Pllc is 1 of 44 dermatology organizations in Texas.
Primary specialty
Dermatology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Peacock
Office Manager
Last NPPES update
2023-12-20
Source: monthly bulk 2026-05
How this organization compares
Across 44 active dermatology providers in Texas.
NPI age
12 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-05Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
11101 Toepperwein Rd
Live Oak, TX 782333048
Mailing address
11101 Toepperwein Rd
Live Oak, TX 782333048
Authorized official
Myra Peacock
Office Manager
📞 2106513233
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Jean-Denis Boucher, M.D. Dermatology NPI 1205827532
Specialties
-
Dermatology PrimaryProcedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery,...
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.