MEDICARE: CLINICAL SPECIALTY INFUSIONS OF DALLAS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251F00000X	Home Infusion Agency
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336M0002X	Mail Order Pharmacy
4	333600000X	Pharmacy
5	3336C0003X	Community/Retail Pharmacy
6	3336S0011X	Specialty Pharmacy
7	3336H0001X	Home Infusion Therapy Pharmacy

General Provider Information

NPI Number	:	1093547705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL SPECIALTY INFUSIONS OF DALLAS, LLC

Provider Business Mailing Address
First Line	:	5340 LEGACY DR STE 115
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-3393
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5429 E BEAUMONT CENTER BLVD STE 820
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5248
Country	:	US
Telephone Number	:	833-569-1005
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF LEGAL AND COMPLIANCE
Name	:	MARITZA MORA
Credential	:
Telephone Number	:	430-213-1563

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	12/02/2024

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