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General NPI Number Information
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NPI Number | 1144418690
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Entity Type | Organization
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Legal Business Name | DALLAS EAR, NOSE & THROAT CENTER PA
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 9301 N CENTRAL EXPY SUITE 560
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City | DALLAS
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State | TX
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Zip | 75231-0806
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Country | US
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Telephone | 214-821-1809
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Fax | 214-827-9037
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Provider Business Mailing Address
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Address Line | 9301 N CENTRAL EXPY SUITE 560
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City | DALLAS
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State | TX
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Zip | 75231-0806
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Country | US
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Telephone | 214-821-1809
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Fax | 214-827-9037
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Authorized Official
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Title or Position | DOCTOR
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Name | MARK A HARDIN
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Credential | M.D.
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Telephone | 214-821-1809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | H1440
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License Number State | TX
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