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General NPI Number Information
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NPI Number | 1316282049
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Entity Type | Organization
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Legal Business Name | A PLATINUM FOUNDATION
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 1921 WINDCHIME DR
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City | DALLAS
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State | TX
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Zip | 75224-4822
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Country | US
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Telephone | 186-667-4604
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Fax |
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Provider Business Mailing Address
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Address Line | 1921 WINDCHIME DR
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City | DALLAS
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State | TX
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Zip | 75224-4822
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Country | US
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Telephone | 186-667-4604
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS BROOKE CHEREE MCGOWAN
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Credential |
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Telephone | 18666746040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | TX
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