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Organization
LAS COLINAS PHYSICAL MEDICINE PLLC
Active
Organization
LAS COLINAS PHYSICAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENNIE BUDET (CREDENTIALING DIRECTOR)
(702) 462-9729
Entity
Organization
Contact information
Practice address
122 W JOHN CARPENTER FWY STE 105, IRVING, TX 75039-2024
(972) 378-0383
(972) 403-3434
Mailing address
122 W JOHN CARPENTER FWY STE 105, IRVING, TX 75039-2024
(972) 378-0383
(972) 403-3434
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/14/2022
Last updated
03/16/2023
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