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General NPI Number Information
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NPI Number | 1265645196
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Entity Type | Organization
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Legal Business Name | STEADFAST GROUP, LLC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1008 STONEWALL ST STE A
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City | GARLAND
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State | TX
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Zip | 75043-1565
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Country | US
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Telephone | 972-278-9840
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 STONEWALL ST STE A
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City | GARLAND
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State | TX
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Zip | 75043-1565
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Country | US
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Telephone | 972-278-9840
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | BIBIANA MORGAN
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Credential |
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Telephone | 972-278-9840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 0095276
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License Number State | TX
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