Healthcare Provider Details

I. General information

NPI: 1275319790
Provider Name (Legal Business Name): ALPHA MEDICINE & REHAB, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N DENTON TAP RD STE 150
COPPELL TX
75019-2162
US

IV. Provider business mailing address

720 N DENTON TAP RD STE 150
COPPELL TX
75019-2162
US

V. Phone/Fax

Practice location:
  • Phone: 469-833-2675
  • Fax:
Mailing address:
  • Phone: 972-415-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINH HUYNH
Title or Position: MEMBER
Credential: MD
Phone: 972-415-1350