Healthcare Provider Details

I. General information

NPI: 1114372810
Provider Name (Legal Business Name): CHELSEA COLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2016
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-7201
US

V. Phone/Fax

Practice location:
  • Phone: 214-590-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberS7627
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS7627
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: