Organization
PANTHEON MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS H BIRD (OWNER)
(214) 954-0406
Entity
Organization
Contact information
Practice address
9535 FOREST LN, SUITE 100A, DALLAS, TX 75243-5900
(214) 954-0406
Mailing address
9535 FOREST LN, SUITE 100A, DALLAS, TX 75243-5900
(214) 954-0406
Taxonomy
Speciality
Code
Description
License number
State
331L00000X
Blood Bank
Primary
—
—
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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