Healthcare Provider Details

I. General information

NPI: 1982144036
Provider Name (Legal Business Name): DITTA SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4054 MCKINNEY AVE STE 202
DALLAS TX
75204-2058
US

IV. Provider business mailing address

7750 N MACARTHUR BLVD # 120-343
IRVING TX
75063-7514
US

V. Phone/Fax

Practice location:
  • Phone: 214-325-0466
  • Fax:
Mailing address:
  • Phone: 214-325-0466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code242T00000X
TaxonomyPerfusionist
License Number
License Number State

VIII. Authorized Official

Name: MAGDALENA SOFIA MULDOON
Title or Position: OWNER/ CERTIFIED TECHNICIAN
Credential:
Phone: 214-325-0466