Organization
LIFEGENIX MED PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE CLEMONS (VP OF OPERATIONS)
(972) 236-3333
Entity
Organization
Contact information
Practice address
17230 DALLAS PKWY STE 110, DALLAS, TX 75248-1136
(972) 236-3333
(972) 920-3754
Mailing address
17230 DALLAS PKWY STE 110, DALLAS, TX 75248-1136
(972) 236-3333
(972) 920-3754
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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