Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Modern Dermatology PLLC

Organization Dermatology Physician · NPI 1356891576

Modern Dermatology PLLC is a Dermatology Physician in Beaumont, Texas. Licensed in Texas. Registered with an NPI since 2016.

Licensed in
TX
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3485 Fannin St
Beaumont, TX 77701-3807
Phone: (409) 835-4790
Fax: (409) 835-2496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence J3153 (TX)

Record details

NPI number1356891576
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Trina West — Office Manager · (409) 835-4790
NPI enumeratedOctober 12, 2016
Last updated in NPPESOctober 12, 2016
Mailing address3485 Fannin St, Beaumont, TX 77701-3807

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