Organization
BOARDWALK PROVIDERS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA ZIMMERMANN (PRACTICE MANAGER)
(972) 406-9911
Entity
Organization
Contact information
Practice address
6750 N MACARTHUR BLVD, STE 100, IRVING, TX 75039-2875
(972) 406-9911
(972) 406-9930
Mailing address
6750 N MACARTHUR BLVD, STE 100, IRVING, TX 75039-2875
(972) 406-9911
(972) 406-9930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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