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General NPI Number Information
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NPI Number | 1275924680
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Entity Type | Organization
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Legal Business Name | TLA HEALTH SERVICES
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Dates
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Enumeration Date | 02/08/2015
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 5425 W SPRING CREEK PKWY STE 115
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City | PLANO
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State | TX
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Zip | 75024-4333
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Country | US
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Telephone | 972-899-9797
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Fax | 469-771-0268
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Provider Business Mailing Address
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Address Line | PO BOX 118917
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City | CARROLLTON
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State | TX
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Zip | 75011-8917
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Country | US
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Telephone | 972-899-9797
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Fax | 972-899-1825
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Authorized Official
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Title or Position | OWNER
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Name | TRACE LAWRENCE ALEXANDER
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Credential | FNP
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Telephone | 972-899-9797
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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