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General NPI Number Information
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NPI Number | 1053873323
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Entity Type | Organization
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Legal Business Name | S&R MERIDIAN MANAGEMENT BC LLC
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 09/27/2019
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Provider Practice Location Address
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Address Line | 5744 LBJ FWY STE 200
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City | DALLAS
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State | TX
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Zip | 75240-6311
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Country | US
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Telephone | 214-273-2648
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Fax |
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Provider Business Mailing Address
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Address Line | 3209 OAK ARBOR DR
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City | PLANO
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State | TX
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Zip | 75093-5979
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Country | US
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Telephone | 972-762-0861
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANJAI ISAAC
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Credential | MD
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Telephone | 717-759-4378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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