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General NPI Number Information
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NPI Number | 1518288596
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Entity Type | Organization
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Legal Business Name | NEOGENESIS CENTER FOR WELLNESS AND ENT ALLERGY, PA
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 5952 ROYAL LN STE 120
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City | DALLAS
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State | TX
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Zip | 75230-3862
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Country | US
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Telephone | 214-691-7546
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Fax | 214-234-0053
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Provider Business Mailing Address
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Address Line | 5952 ROYAL LN STE 120
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City | DALLAS
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State | TX
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Zip | 75230-3862
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Country | US
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Telephone | 214-691-7546
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Fax | 214-234-0053
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Authorized Official
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Title or Position | OWNER
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Name | DR. REYNALDO C SANCHEZ
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Credential | M.D.
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Telephone | 214-691-7546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | E2838
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License Number State | TX
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