Organization
DFW 5.01 (A) CORPORATION
Active
Other names
Mary Shiels
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN A. DILLEMUTH (ASSISTANT TREASURY)
(561) 712-6242
Entity
Organization
Contact information
Practice address
3515 HOWELL STREET, DALLAS, TX 75204
(972) 404-9345
(972) 404-2506
Mailing address
14275 MIDWAY ROAD, SUITE 400, ADDISON, TX 75001
(214) 932-8234
(214) 932-8284
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
TX
Other
Enumeration date
09/19/2006
Last updated
08/22/2020
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