Organization
SILVERLAKE PROFESSIONAL GROUP
Active
Other names
Silverlake Medical Group, Timber Lake Consulting, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP TALLEY FNP (OWNER)
(323) 524-4434
Entity
Organization
Contact information
Practice address
2104 KIMBALL HILL CT, SOUTHLAKE, TX 76092-7914
(432) 352-4443
Mailing address
2104 KIMBALL HILL CT, SOUTHLAKE, TX 76092-7914
(432) 352-4443
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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