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

Premier Procedural Dermatology PLLC

Organization MOHS-Micrographic Surgery Physician · NPI 1053969287

Premier Procedural Dermatology PLLC is an MOHS-Micrographic Surgery Physician in College Station, Texas. Registered with an NPI since 2019.

In the registry since
2019
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

1651 Rock Prairie Rd Ste 103
College Station, TX 77845-8652
Phone: (979) 314-5400
Fax: (979) 704-5603
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X

Record details

NPI number1053969287
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Ahern — Provider/Owner · (979) 314-5400
NPI enumeratedAugust 30, 2019
Last updated in NPPESApril 3, 2020
Certification dateApril 3, 2020
Mailing address1651 Rock Prairie Rd Ste 103, College Station, TX 77845-8652

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