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General NPI Number Information
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NPI Number | 1184733362
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Entity Type | Organization
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Legal Business Name | ECSC II PA
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5421 LA SIERRA DR
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City | DALLAS
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State | TX
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Zip | 75231-4107
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Country | US
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Telephone | 214-361-1443
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Fax | 214-691-3299
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Provider Business Mailing Address
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Address Line | 5421 LA SIERRA DR
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City | DALLAS
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State | TX
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Zip | 75231-4107
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Country | US
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Telephone | 214-361-1443
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Fax | 214-691-3299
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Authorized Official
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Title or Position | COO
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Name | HALLIE BLEDSUE
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Credential |
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Telephone | 214-361-1443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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