| |
9780 Walnut St, Suite 200, Dallas, TX 75243-2389 | |
(972) 792-7031 | |
(972) 792-7037 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 9780 Walnut St, Dallas, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437307139 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | F007607 (Texas) | Secondary |
207Q00000X | Family Medicine | F007607 (Texas) | Primary |
Mailing Address | Practice Location Address |
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9780 Walnut St, Suite 200, Dallas, TX 75243-2389 Ph: (972) 792-7031 | 9780 Walnut St, Suite 200, Dallas, TX 75243-2389 Ph: (972) 792-7031 |