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General NPI Number Information
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NPI Number | 1801118997
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Entity Type | Organization
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Legal Business Name | MFM FACT, PLLC
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 7777 FOREST LN SUITE C-336
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City | DALLAS
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State | TX
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Zip | 75230-2505
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Country | US
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Telephone | 972-566-8585
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Fax | 972-566-8576
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN SUITE C-336
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City | DALLAS
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State | TX
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Zip | 75230-2505
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Country | US
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Telephone | 972-566-8585
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Fax | 972-566-8576
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JEFF HENDERSON
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Credential |
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Telephone | 972-401-8720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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