MEDICARE: CHECK POINT HEALTH 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	207QA0505X	Adult Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P1395	OTHER	TX	TEXAS MEDICAL LICENSE
2	AP140556	OTHER	TX	APN LICENSE NUMBER

General Provider Information

NPI Number	:	1225665680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHECK POINT HEALTH LLC

Provider Business Mailing Address
First Line	:	6207 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5114
Country	:	US
Telephone Number	:	469-358-7292
Fax Number	:

Provider Business Practice Location Address
First Line	:	6207 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5114
Country	:	US
Telephone Number	:	469-358-7292
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/DON
Name	:	JENNA HYLAND
Credential	:	RN
Telephone Number	:	469-660-4601

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	07/20/2020

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Directions to “CHECK POINT HEALTH LLC ” Practice Location

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