Healthcare Provider Details

I. General information

NPI: 1437120045
Provider Name (Legal Business Name): DFW 501A CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 MATLOCK RD
ARLINGTON TX
76015-2908
US

IV. Provider business mailing address

14275 MIDWAY RD SUITE 400
ADDISON TX
75001-3614
US

V. Phone/Fax

Practice location:
  • Phone: 817-472-4840
  • Fax: 817-472-4954
Mailing address:
  • Phone:
  • Fax: 610-271-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DARREN THOMAS WHEELER
Title or Position: VICE PRESIDENT
Credential:
Phone: 702-733-7866