Healthcare Provider Details

I. General information

NPI: 1457704199
Provider Name (Legal Business Name): RHRR MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 CYPRESS WATERS BLVD STE 190
COPPELL TX
75019-4594
US

IV. Provider business mailing address

PO BOX 206579
DALLAS TX
75320-6579
US

V. Phone/Fax

Practice location:
  • Phone: 817-485-5100
  • Fax:
Mailing address:
  • Phone: 817-485-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES C NEFF
Title or Position: DIRECTOR
Credential:
Phone: 817-485-5100