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Organization

DALLAS ID ASSOCIATES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN WALKER (PRACTICE ADMINISTRATOR)
(214) 689-7806
Entity
Organization

Contact information

Practice address
1600 W COLLEGE ST STE 130, GRAPEVINE, TX 76051-3575
(214) 689-7806
(214) 689-5970
Mailing address
1600 W COLLEGE ST STE 130, GRAPEVINE, TX 76051-3575
(214) 689-7806
(214) 689-5970

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141563001
TX
05
141563003
TX
Enumeration date
07/04/2006
Last updated
06/16/2023
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