Healthcare Provider Details

I. General information

NPI: 1386940450
Provider Name (Legal Business Name): JUSTIN FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 WALNUT HILL LN STE 615
DALLAS TX
75231-4424
US

IV. Provider business mailing address

8220 WALNUT HILL LN STE 615
DALLAS TX
75231-4424
US

V. Phone/Fax

Practice location:
  • Phone: 214-345-8393
  • Fax: 214-345-8409
Mailing address:
  • Phone: 214-345-8393
  • Fax: 214-345-8409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA116538
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME116497
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberR7996
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: