Healthcare Provider Details

I. General information

NPI: 1801519491
Provider Name (Legal Business Name): MEDIGY GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 09/20/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 N CENTRAL EXPY STE 307
DALLAS TX
75206-4173
US

IV. Provider business mailing address

6440 N CENTRAL EXPY STE 307
DALLAS TX
75206-4173
US

V. Phone/Fax

Practice location:
  • Phone: 817-379-6334
  • Fax: 817-379-6335
Mailing address:
  • Phone: 817-379-6334
  • Fax: 817-379-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: TERESA LYNNE VEGA
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 817-379-6334