Life Span Medicine Pa in Dallas - General Practice
Life Span Medicine Pa - NPI 1679514632
Life Span Medicine Pa is a General Practice in Dallas, Texas. Life Span Medicine Pa practices all healthcare services and medical treatments related to General Practice. The NPI Number for Life Span Medicine Pa is 1679514632. The last update date is 2010-04-07.
Life Span Medicine Pa's current location address is 2706 Fairmont Street, Dallas, Texas. You can contact this provider via phone number 2143031888 and fax number 2143031550. The mailing address for Life Span Medicine Pa is 2706 Fairmont Street, Dallas, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Life Span Medicine Pa |
|---|---|
| Address | 2706 Fairmont Street, Dallas, Texas |
| Phone Number | 2143031888 |
| Fax Number | 2143031550 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Renna Gina |
| Telephone Number | 2143031888 |
NPI Number Detail
| NPI Number | 1679514632 |
|---|---|
| Provider Enumeration Date | 2006-06-09 |
| Last Updated Date | 2010-04-07 |
Provider Mailing Address Detail
| Address | 2706 Fairmont Street |
|---|---|
| City | Dallas |
| State | Texas (TX) |
| Post Code | 75201 |
| Phone Number | 2143031888 |
| Fax Number | 2143031550 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0036HZ | BLUE CROSS |
Post Comment/ Review Below
What is the unique identifier code issued to Life Span Medicine Pa by the Centers for Medicare & Medicaid Services?
The Life Span Medicine Pa has been assigned the NPI (National Provider Identifier) 1679514632. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Life Span Medicine Pa's physical address?
The Life Span Medicine Pa is physically located at 2706 Fairmont Street, in the city of Dallas, TX, with the postal code 75201.
What is the Life Span Medicine Pa's area of specialization and corresponding taxonomy classification?
The Life Span Medicine Pa's specialty field is General Practice, and it falls under the taxonomy code 208D00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1679514632 to Life Span Medicine Pa?
The Centers for Medicare & Medicaid Services originally issued the 1679514632 to Life Span Medicine Pa on 2006-06-09.
As of what date were the details pertaining to Life Span Medicine Pa last refreshed?
The information related to the Life Span Medicine Pa, including its address, specialty, and other relevant details, was last updated on 2010-04-07.