Lone Star State Dermatology Clinic PLLC
NPI 1053723239 · Procedural Dermatology Physician · Live Oak, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lone Star State Dermatology Clinic PLLC is a Procedural Dermatology Physician organization in Live Oak, TX (NPI 1053723239).
Provider details
- NPI number
- 1053723239
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Myra Peacock, Office Manager(210) 651-3233
- License
- K8022 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-05-22
- Last updated
- 2023-12-20
- Certified
- 2023-12-20
Frequently asked questions
- What is Lone Star State Dermatology Clinic PLLC's NPI number?
- Lone Star State Dermatology Clinic PLLC's National Provider Identifier (NPI) is 1053723239, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lone Star State Dermatology Clinic PLLC?
- Lone Star State Dermatology Clinic PLLC is classified in the NPPES registry as Procedural Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Lone Star State Dermatology Clinic PLLC located?
- Lone Star State Dermatology Clinic PLLC's practice location on file with NPPES is 11101 Toepperwein Rd, Live Oak, TX 78233-3048.
- What is Lone Star State Dermatology Clinic PLLC's phone number?
- The practice phone number listed in the NPPES registry for Lone Star State Dermatology Clinic PLLC is (210) 651-3233.
- Does Lone Star State Dermatology Clinic PLLC accept Medicare?
- Lone Star State Dermatology Clinic PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lone Star State Dermatology Clinic PLLC?
- The authorized official listed on Lone Star State Dermatology Clinic PLLC's NPPES record is Myra Peacock, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lone Star State Dermatology Clinic PLLC's NPI active?
- Yes — Lone Star State Dermatology Clinic PLLC's NPI (1053723239) is active in the NPPES registry as of the last update on 2023-12-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.