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General NPI Number Information
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NPI Number | 1861802902
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Entity Type | Organization
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Legal Business Name | DALLAS MEDICAL PHYSICIAN GROUP
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 1100 ALLIED DR
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City | PLANO
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State | TX
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Zip | 75093-5348
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Country | US
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Telephone | 972-488-9656
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 678040
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City | DALLAS
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State | TX
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Zip | 75267-8040
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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 | PRESIDENT/CEO
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Name | RAJESWARI KUMAR
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Credential |
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Telephone | 972-888-7099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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