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General NPI Number Information
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NPI Number | 1457544694
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Entity Type | Organization
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Legal Business Name | DYNAL M LONDON PA
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 6900 SCENIC DR 103
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City | ROWLETT
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State | TX
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Zip | 75088-2695
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Country | US
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Telephone | 972-412-1034
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Fax | 972-475-5708
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Provider Business Mailing Address
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Address Line | 6900 SCENIC DR 103
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City | ROWLETT
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State | TX
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Zip | 75088-2695
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Country | US
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Telephone | 972-412-1034
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Fax | 972-475-5708
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DYNAL M LONDON
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Credential | MD
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Telephone | 972-412-1034
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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 | K2060
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License Number State | TX
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