=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568606887
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMERGENCY MEDICINE PHYSICIANS OF DALLAS PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2009
-----------------------------------------------------
Last Update Date | 02/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8611 HILLCREST AVE STE 180
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75225-4214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-368-3800
-----------------------------------------------------
Fax | 214-360-7724
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8611 HILLCREST AVE STE 180
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75225-4214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-368-3800
-----------------------------------------------------
Fax | 214-360-7724
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | DR. MARLON DAYMOND PADILLA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 214-368-3800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------