OrganizationActive
Ladera Park Dermatology PA
NPI 1225567704 · Dermatology Physician · Austin, TX
Provider details
- NPI number
- 1225567704
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Adrienne Feasel, President(512) 345-3599
- License
- L2883 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
11671 Jollyville Rd Ste 104
Austin, TX 78759-4141
Phone: (512) 345-3599
Fax: (512) 345-3928
Street-level locationGet directions
Mailing address
11671 Jollyville Rd Ste 104
Austin, TX 78759-4141
Other names (DBA / former)
- Former legal business name
- Lake Travis Dermatology PA
Registry dates
- Enumerated
- 2017-06-08
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.