MEDICARE: SIERRA HEALTHCARE NETWORK LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1194368266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIERRA HEALTHCARE NETWORK LLC

Provider Business Mailing Address
First Line	:	2727 LBJ FWY STE 326
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7478
Country	:	US
Telephone Number	:	214-935-5777
Fax Number	:	214-935-5717

Provider Business Practice Location Address
First Line	:	2727 LBJ FWY STE 326
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7478
Country	:	US
Telephone Number	:	214-935-5777
Fax Number	:	214-935-5717

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ROSELINE JONES
Credential	:	FNP
Telephone Number	:	469-335-2356

Provider Enumeration Date	:	10/22/2019
Last Update Date	:	11/08/2024

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Directions to “SIERRA HEALTHCARE NETWORK LLC ” Practice Location

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