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General NPI Number Information
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NPI Number | 1063955334
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Entity Type | Organization
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Legal Business Name | TRAVELING DOCTORS, LLC
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 8508 SIKORSKI LN
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City | DALLAS
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State | TX
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Zip | 75228-5447
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Country | US
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Telephone | 469-230-2291
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Fax |
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Provider Business Mailing Address
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Address Line | 8508 SIKORSKI LN
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City | DALLAS
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State | TX
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Zip | 75228-5447
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Country | US
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Telephone | 469-230-2291
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID CORIA
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Credential |
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Telephone | 469-230-2291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | L1276
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License Number State | TX
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