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General NPI Number Information
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NPI Number | 1699314690
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Entity Type | Organization
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Legal Business Name | DYANA LLC
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 3010 LEGACY DR STE 130
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City | FRISCO
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State | TX
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Zip | 75034-7631
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Country | US
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Telephone | 214-618-1676
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 COPPER MOUNTAIN LN
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City | RICHARDSON
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State | TX
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Zip | 75082-3892
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Country | US
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Telephone | 214-505-7107
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAI KUMAR
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Credential |
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Telephone | 214-505-7107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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