Healthcare Provider Details

I. General information

NPI: 1356365860
Provider Name (Legal Business Name): RICHARD MITCHELL DASHEIFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 SPRING MOUNTAIN DR
PLANO TX
75025-4367
US

IV. Provider business mailing address

3609 SPRING MOUNTAIN DR
PLANO TX
75025-4367
US

V. Phone/Fax

Practice location:
  • Phone: 214-387-0943
  • Fax:
Mailing address:
  • Phone: 214-387-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberJ8985
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: