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General NPI Number Information
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NPI Number | 1790718484
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Entity Type | Organization
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Legal Business Name | WHITE ROCK PULMONARY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 9330 POPPY DRIVE SUITE #407
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City | DALLAS
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State | TX
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Zip | 75218-3403
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Country | US
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Telephone | 214-328-5487
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Fax | 214-328-0419
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Provider Business Mailing Address
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Address Line | 9330 POPPY DRIVE SUITE #407
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City | DALLAS
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State | TX
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Zip | 75218-3403
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Country | US
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Telephone | 214-328-5487
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Fax | 214-328-0419
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK C. FERRIS
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Credential | M.D.
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Telephone | 214-328-5487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease 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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | J5758
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | J5758
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License Number State | TX
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