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General NPI Number Information
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NPI Number | 1285145532
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Entity Type | Organization
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Legal Business Name | CLA PHYSICIANS GROUP INC
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 17110 DALLAS PKWY STE 105
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City | DALLAS
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State | TX
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Zip | 75248-1146
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Country | US
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Telephone | 972-483-5714
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Fax | 469-331-0097
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Provider Business Mailing Address
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Address Line | 17110 DALLAS PKWY STE 105
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City | DALLAS
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State | TX
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Zip | 75248-1146
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Country | US
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Telephone | 972-483-5714
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Fax | 469-331-0097
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Authorized Official
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Title or Position | CEO
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Name | MR. JOACHIM COLEMAN FIIHR
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Credential |
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Telephone | 469-667-6122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | K5159
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | K5159
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License Number State | TX
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