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Organization
MANUEL GRIEGO JR. DO PA
Active
Organization
MANUEL GRIEGO JR. DO PA
Active
Other names
Fair Park Medical Centre
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL GRIEGO JR. DO (CEO/PRESIDENT)
(214) 580-7277
Entity
Organization
Contact information
Practice address
3116 MARTIN LUTHER KING JR BLVD, DALLAS, TX 75215-2414
(214) 329-3300
Mailing address
1412 MAIN ST, SUITE 905, DALLAS, TX 75202-4014
(214) 580-7277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F1604
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000HL68
—
TX
Enumeration date
07/27/2007
Last updated
07/06/2010
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