# THRIVE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871910505
- **Authorized official:** DR. CLINTON F HERZOG DDS (OWNER)
- **Authorized official phone:** (214) 420-0100

## Contact information

- **Practice address:** 4020 OAK LAWN AVE, DALLAS, TX 75219-3134
- **Practice address phone:** (214) 420-0100
- **Practice address fax:** (214) 420-0101
- **Mailing address:** 4020 OAK LAWN AVE, DALLAS, TX 75219-3134
- **Mailing address phone:** (214) 420-0100
- **Mailing address fax:** (214) 420-0101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | H4764 | TX | Yes |

## Other

- **Enumeration date:** 03/19/2014
- **Last updated:** 03/19/2014