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NPI Code Detail

MEDICARE: BREAST SURGEONS OF NORTH TEXAS

MEDICARE: BREAST SURGEONS OF NORTH TEXAS
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
1174400000XSpecialistJ2651TX

General Provider Information

NPI Number : 1730308453
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREAST SURGEONS OF NORTH TEXAS
Provider Business Mailing Address
First Line : 7777 FOREST LN C614
Second Line :
City : DALLAS
State : TX
Zip : 75230
Country : US
Telephone Number : 972-566-5872
Fax Number : 972-566-6614
Provider Business Practice Location Address
First Line : 7777 FOREST LN STE C614
Second Line :
City : DALLAS
State : TX
Zip : 75230-6856
Country : US
Telephone Number : 972-566-5872
Fax Number : 972-566-6614
Authorized Official
Title or Position : OWNER
Name : DR. ALISON L LAIDLEY
Credential : M.D.
Telephone Number : 972-566-5872
Provider Enumeration Date : 04/24/2007
Last Update Date : 08/22/2020

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Directions to “BREAST SURGEONS OF NORTH TEXAS ” Practice Location

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