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General NPI Number Information
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NPI Number | 1780823054
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Entity Type | Organization
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Legal Business Name | HEALTHCARE LIAISON PROFESSIONALS, INC
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 1513 VICEROY DR SUITE
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City | DALLAS
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State | TX
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Zip | 75235-2303
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Country | US
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Telephone | 214-244-9114
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Fax |
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Provider Business Mailing Address
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Address Line | 1513 VICEROY DR SUITE 101
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City | DALLAS
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State | TX
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Zip | 75235-2303
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Country | US
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Telephone | 214-244-9114
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NOBLE EZUKANMA
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Credential | M.D.
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Telephone | 469-595-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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