=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952063323
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERMOGRAPHY CENTER OF DALLAS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2021
-----------------------------------------------------
Last Update Date | 10/12/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5220 SPRING VALLEY RD STE LL40
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75254-1955
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-352-8758
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5220 SPRING VALLEY RD STE LL40
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75254-1955
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-352-8758
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MATTHEW EINSOHN
-----------------------------------------------------
Credential | ND
-----------------------------------------------------
Telephone | 214-352-8758
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------