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General NPI Number Information
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NPI Number | 1912340100
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Entity Type | Organization
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Legal Business Name | PULMONARY PREVENTION PLUS LLC
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 3030 LYNDON B JOHNSON FWY # 940
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City | DALLAS
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State | TX
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Zip | 75234-7781
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Country | US
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Telephone | 469-371-4910
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Fax | 214-242-3553
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Provider Business Mailing Address
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Address Line | 3030 LYNDON B JOHNSON FWY # 940
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City | DALLAS
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State | TX
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Zip | 75234-7781
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Country | US
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Telephone | 469-371-4910
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Fax | 214-242-3553
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Authorized Official
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Title or Position | CEO
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Name | MR. DANIEL POLK JR.
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Credential |
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Telephone | 469-371-4910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1001108
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License Number State | TX
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