OrganizationActive
Teton Dermatology LLC
NPI 1194044750 · Dermatology Physician · Jackson, WY
Provider details
- NPI number
- 1194044750
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gheorghe Pusta, Executive Director(512) 628-0465
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
984 West Broadway
Suite 4
Jackson, WY 83001-0000
Phone: (307) 734-1800
Fax: (307) 734-5012
Approximate (ZIP-level) locationGet directions
Mailing address
7300 Ranch Rd. 2222, Bldg 1, Ste 200
Austin, TX 78730
Registry dates
- Enumerated
- 2010-05-21
- Last updated
- 2024-09-18
- Certified
- 2024-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.