| Imadulation International, Lp | |
|
17304 Preston Rd #800 Dallas TX 75252-5618 | |
| (972) 880-0102 | |
| Not Available |
| Full Name | Imadulation International, Lp |
|---|---|
| Speciality | Counselor - Professional |
| Location | 17304 Preston Rd, Dallas, Texas |
| Authorized Official Name and Position | Ellen Simon (PRESIDENT/FOUNDER) |
| Authorized Official Contact | 9728800102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imadulation International, Lp 7201 Cutter Mill Dr Dallas TX 75248-1609 Ph: (972) 880-0102 | Imadulation International, Lp 17304 Preston Rd #800 Dallas TX 75252-5618 Ph: (972) 880-0102 |
| NPI Number | 1780914556 |
|---|---|
| Provider Enumeration Date | 12/30/2009 |
| Last Update Date | 07/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780914556 | NPI | - | NPPES |
| 3705 LC | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 14751 (Texas) | Primary |
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