Healthcare Provider Details

I. General information

NPI: 1689927394
Provider Name (Legal Business Name): APPLIED NEUROLOGY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2012
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17311 DALLAS PKWY SUITE 205
DALLAS TX
75248-1141
US

IV. Provider business mailing address

17311 DALLAS PKWY SUITE 205
DALLAS TX
75248-1141
US

V. Phone/Fax

Practice location:
  • Phone: 214-227-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number12047
License Number StateTX

VIII. Authorized Official

Name: DAN SULLINS
Title or Position: DR.
Credential:
Phone: 214-227-7300