Healthcare Provider Details

I. General information

NPI: 1639506173
Provider Name (Legal Business Name): WCML MANAGEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 LBJ FWY SUITE 360
DALLAS TX
75240-6217
US

IV. Provider business mailing address

5550 LBJ FWY SUITE 360
DALLAS TX
75240-6217
US

V. Phone/Fax

Practice location:
  • Phone: 972-996-0900
  • Fax: 972-996-0905
Mailing address:
  • Phone: 972-996-0900
  • Fax: 972-996-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS CHARLOTTE L BURNS
Title or Position: PRESIDENT
Credential:
Phone: 972-996-0900