MEDICARE: DALLAS DOCTORS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0100X	Occupational Health Chiropractor	5590	TX
2	2251X0800X	Orthopedic Physical Therapist	1055530	TX
3	207QS0010X	Sports Medicine (Family Medicine) Physician	L8125	TX

General Provider Information

NPI Number	:	1558567784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS DOCTORS, PA

Provider Business Mailing Address
First Line	:	PO BOX 781667
Second Line	:	SUITE 3105
City	:	DALLAS
State	:	TX
Zip	:	75378-1667
Country	:	US
Telephone Number	:	214-352-3000
Fax Number	:	214-358-2418

Provider Business Practice Location Address
First Line	:	2351 W NORTHWEST HWY
Second Line	:	SUITE 3100
City	:	DALLAS
State	:	TX
Zip	:	75220-4433
Country	:	US
Telephone Number	:	214-352-3000
Fax Number	:	214-358-2418

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. JEFF JAVIER RODRIGUEZ
Credential	:	D.C.
Telephone Number	:	214-352-3000

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	09/20/2024

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2351 W NORTHWEST HWY , STE 3100
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1568680650 — GREGORY L WATTRON O.T.R.
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2351 W NORTHWEST HWY , SUITE 3100
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2351 W NORTHWEST HWY , SUITE 3245
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Directions to “DALLAS DOCTORS, PA ” Practice Location

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