Organization
CHARLES A ILIYA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES A ILIYA M.D. (PRESIDENT)
(214) 321-2481
Entity
Organization
Contact information
Practice address
9330 POPPY DR, SUITE 500, DALLAS, TX 75218-4612
(214) 321-2481
(214) 324-1478
Mailing address
9330 POPPY DR, SUITE 500, DALLAS, TX 75218-4612
(214) 321-2481
(214) 324-1478
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G5202
TX
2086S0129X
Vascular Surgery Physician
G5202
TX
Other
Enumeration date
11/16/2011
Last updated
08/20/2016
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