Healthcare Provider Details

I. General information

NPI: 1942730841
Provider Name (Legal Business Name): LPP OF TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MEDICAL PKWY
DALLAS TX
75234-7829
US

IV. Provider business mailing address

211 COMMERCE ST STE 800
NASHVILLE TN
37201-1817
US

V. Phone/Fax

Practice location:
  • Phone: 972-888-7000
  • Fax:
Mailing address:
  • Phone: 712-210-6744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER R KELLY
Title or Position: CHAIRMAN & CEO
Credential:
Phone: 615-554-6885