Organization
VP MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELTON WAYNE BAZZLE (CEO)
(214) 698-0600
Entity
Organization
Contact information
Practice address
3406 MAIN ST, DALLAS, TX 75226-1642
(214) 698-0600
Mailing address
3406 MAIN ST, DALLAS, TX 75226-1642
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/25/2011
Last updated
05/26/2011
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