Healthcare Provider Details

I. General information

NPI: 1215654991
Provider Name (Legal Business Name): DCOHW GPS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 FOREST LN STE A309
DALLAS TX
75230-2507
US

IV. Provider business mailing address

7777 FOREST LN STE A309
DALLAS TX
75230-2507
US

V. Phone/Fax

Practice location:
  • Phone: 972-566-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM LITTLE
Title or Position: CO-OWNER
Credential:
Phone: 870-243-4406