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General NPI Number Information
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NPI Number | 1568961555
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Entity Type | Individual
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Provider Name | MR. RUFUS C HARDY JR.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 02/06/2018
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Provider Practice Location Address
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Address Line | 1714 DOLORES WAY
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City | DALLAS
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State | TX
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Zip | 75232-4244
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Country | US
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Telephone | 817-253-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 7504 ARABIAN CIRCLEW
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City | FLOWER MOUND
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State | TX
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Zip | 75022
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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