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General NPI Number Information
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NPI Number | 1821844366
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Entity Type | Organization
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Legal Business Name | TEXAS FITMIND
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 5955 ALPHA RD
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City | DALLAS
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State | TX
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Zip | 75240-1121
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Country | US
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Telephone | 214-226-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 5955 ALPHA RD # 1507
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City | DALLAS
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State | TX
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Zip | 75240-1121
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES AVERY
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Credential | MD
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Telephone | 817-752-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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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 | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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