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General NPI Number Information
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NPI Number | 1356377337
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Entity Type | Organization
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Legal Business Name | SPORTSMEDCENTRAL
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10233 E NORTHWEST HWY SUITE 516
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City | DALLAS
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State | TX
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Zip | 75238-4432
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Country | US
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Telephone | 214-343-2300
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Fax | 214-343-4178
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Provider Business Mailing Address
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Address Line | 10233 E NORTHWEST HWY SUITE 516
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City | DALLAS
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State | TX
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Zip | 75238-4432
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Country | US
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Telephone | 214-343-2300
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Fax | 214-343-4178
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Authorized Official
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Title or Position | CFO
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Name | MISS DONNA MARIE ALFORD
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Credential |
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Telephone | 214-343-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | TX
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