Healthcare Provider Details

I. General information

NPI: 1932469327
Provider Name (Legal Business Name): IAN M CORCORAN-SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 WELBORN ST TSRH - DEPARTMENT OF ORTHOPAEDIC SURGERY
DALLAS TX
75219-3924
US

IV. Provider business mailing address

2222 WELBORN ST DEPARTMENT OF ORTHOPAEDIC SURGERY
DALLAS TX
75219-3924
US

V. Phone/Fax

Practice location:
  • Phone: 214-559-8430
  • Fax: 214-559-7570
Mailing address:
  • Phone: 214-559-8430
  • Fax: 214-559-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR3816
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: