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General NPI Number Information
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NPI Number | 1295221786
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Entity Type | Organization
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Legal Business Name | CORNERSTONEMD,PLLC
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Dates
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Enumeration Date | 07/08/2018
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 12222 N CENTRAL EXPY STE 140
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City | DALLAS
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State | TX
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Zip | 75243
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Country | US
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Telephone | 469-801-8480
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Fax | 214-575-8480
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Provider Business Mailing Address
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Address Line | 12222 N CENTRAL EXPY STE 140
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City | DALLAS
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State | TX
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Zip | 75243-3755
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Country | US
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Telephone | 469-801-8480
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Fax | 214-575-8484
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. CAROLYN KENIA ROSS RILEY
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Credential | MD
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Telephone | 469-801-8480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | Q3590
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License Number State | TX
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