Organization
ORTHOPEDIC ASSOCIATES OF DALLAS, LLP
Active
Parent organization
ORTHOPEDIC ASSOCIATES OF DALLAS, LLP
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHOPEDIC ASSOCIATES OF DALLAS, LLP
Authorized official
TRACY JACKSON (EXECUTIVE DIRECTOR)
(214) 823-7090
Entity
Organization
Contact information
Practice address
11613 N CENTRAL EXPY, SUITE 108, DALLAS, TX 75243-3820
(214) 987-1622
(214) 987-1631
Mailing address
PO BOX 650500, DALLAS, TX 75265-0500
(214) 369-8555
(214) 369-2683
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K730
BCBS
TX
05
—
083558901
—
TX
Enumeration date
05/09/2007
Last updated
10/08/2008
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