Organization
LIFE SPAN MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA RENNA (CEO)
(214) 303-1888
Entity
Organization
Contact information
Practice address
2706 FAIRMONT STREET, DALLAS, TX 75201
(214) 303-1888
(214) 303-1550
Mailing address
2706 FAIRMONT STREET, DALLAS, TX 75201
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036HZ
BLUE CROSS
—
Enumeration date
06/09/2006
Last updated
04/07/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us