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General NPI Number Information
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NPI Number | 1710390463
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Entity Type | Organization
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Legal Business Name | SMART BEAT
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 2909 COLE AVE STE 300
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City | DALLAS
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State | TX
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Zip | 75204
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Country | US
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Telephone | 469-955-4427
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Fax | 469-532-0218
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Provider Business Mailing Address
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Address Line | 2909 COLE AVE STE 300
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City | DALLAS
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State | TX
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Zip | 75204-1310
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Country | US
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Telephone | 469-955-4427
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Fax | 469-532-0218
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Authorized Official
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Title or Position | CEO
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Name | JEFFERY C GUEST
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Credential |
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Telephone | 469-955-4427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | 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 | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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