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General NPI Number Information
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NPI Number | 1245552736
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Entity Type | Organization
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Legal Business Name | TELOS CONSULTING, LLC
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Dates
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Enumeration Date | 02/24/2010
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 13701 DALLAS PARKWAY
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City | DALLAS
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State | TX
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Zip | 75240
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Country | US
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Telephone | 972-386-2560
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Fax | 972-386-2528
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Provider Business Mailing Address
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Address Line | 13701 DALLAS PARKWAY
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City | DALLAS
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State | TX
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Zip | 75240
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Country | US
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Telephone | 972-386-2560
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Fax | 972-386-2528
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | BRENT JUSTICE DARDEN
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Credential |
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Telephone | 972-458-2582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8250
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License Number State | TX
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