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General NPI Number Information
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NPI Number | 1629254503
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Entity Type | Organization
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Legal Business Name | INNOVATIVE MEDICAL SOLUTIONS INC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 03/20/2009
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Provider Practice Location Address
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Address Line | 8616 GREENVILLE AVE STE 100
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City | DALLAS
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State | TX
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Zip | 75243-7166
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Country | US
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Telephone | 214-272-9710
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 802021
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City | DALLAS
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State | TX
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Zip | 75380-2021
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Country | US
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Telephone | 972-770-2860
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. QUAN NGUYEN
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Credential | MD
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Telephone | 972-897-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | M1979
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License Number State | TX
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