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General NPI Number Information
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NPI Number | 1154173987
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Entity Type | Organization
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Legal Business Name | BLUE ZONE MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 4040 LEGACY DR STE 203
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City | FRISCO
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State | TX
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Zip | 75034-6748
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Country | US
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Telephone | 214-618-7746
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Fax | 214-377-6243
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Provider Business Mailing Address
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Address Line | 4040 LEGACY DR STE 203
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City | FRISCO
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State | TX
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Zip | 75034-6748
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Country | US
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Telephone | 214-618-7746
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Fax | 214-377-6243
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. MATTHEW SCHINDLBECK
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Credential | DC
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Telephone | 972-781-1878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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