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General NPI Number Information
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NPI Number | 1245696806
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Entity Type | Organization
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Legal Business Name | DALLAS DIABETES AND ENDOCRINE CENTER
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 7777 FOREST LN SUITE C-685
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-7799
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Fax | 972-566-7399
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN SUITE C-685
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-7799
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Fax | 972-566-7399
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SALOMON BANARER
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Credential | MD
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Telephone | 972-566-7799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | M1490
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License Number State | TX
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