Organization
IARI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN PRICE (ADMINISTRATOR)
(214) 450-9926
Entity
Organization
Contact information
Practice address
12606 GREENVILLE AVE STE 190B, DALLAS, TX 75243-1921
(972) 945-0234
Mailing address
PO BOX 797912, DALLAS, TX 75379-7912
(214) 390-7697
(972) 432-6692
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
06/01/2020
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