Organization
ECSC II PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALLIE BLEDSUE (COO)
(214) 361-1443
Entity
Organization
Contact information
Practice address
5421 LA SIERRA DR, DALLAS, TX 75231-4107
(214) 361-1443
(214) 691-3299
Mailing address
5421 LA SIERRA DR, DALLAS, TX 75231-4107
(214) 361-1443
(214) 691-3299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121664001
—
TX
05
—
121664002
—
TX
05
—
121664005
—
TX
Enumeration date
08/30/2006
Last updated
02/03/2025
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