Organization
ADDISON HEADACHE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (MANAGER)
(972) 234-4740
Entity
Organization
Contact information
Practice address
17051 DALLAS PKWY, STE 100, ADDISON, TX 75001-7101
(469) 916-0521
(972) 231-7095
Mailing address
PO BOX 674183, DALLAS, TX 75267-4183
(972) 479-1115
(972) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/24/2014
Last updated
06/06/2016
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