Healthcare Provider Details

I. General information

NPI: 1174779722
Provider Name (Legal Business Name): IMPAIRMENT & DISABILITY ANALYSIS, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BRYAN ST STE 1900
DALLAS TX
75201-3002
US

IV. Provider business mailing address

PO BOX 140310
DALLAS TX
75214-0310
US

V. Phone/Fax

Practice location:
  • Phone: 866-728-6544
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK HALL
Title or Position: PARTNER
Credential:
Phone: 866-728-6544