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General NPI Number Information
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NPI Number | 1689115644
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Entity Type | Organization
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Legal Business Name | PRINCIPIUM HEALTH LLC
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 4055 VALLEY VIEW LN SUITE 400
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City | DALLAS
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State | TX
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Zip | 75244-5074
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Country | US
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Telephone | 844-425-3183
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Fax | 888-979-8667
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Provider Business Mailing Address
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Address Line | 4055 VALLEY VIEW LN SUITE 400
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City | DALLAS
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State | TX
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Zip | 75244-5074
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Country | US
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Telephone | 844-425-3183
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Fax | 888-979-8667
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Authorized Official
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Title or Position | SVP, CORPORATE OPERATIONS
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Name | MRS. MEAGHAN H JONES
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Credential |
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Telephone | 468-466-7401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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