MEDICARE: PHYSICIANS INTEREST, LP

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1275985277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS INTEREST, LP

Provider Business Mailing Address
First Line	:	6125 LUTHER LN # 175
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-6202
Country	:	US
Telephone Number	:	214-269-3875
Fax Number	:	903-328-6568

Provider Business Practice Location Address
First Line	:	6125 LUTHER LN # 175
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-6202
Country	:	US
Telephone Number	:	214-269-3875
Fax Number	:	903-328-6568

Authorized Official
Title or Position	:	MANAGER
Name	:	PAUL SCHULMAN
Credential	:
Telephone Number	:	214-315-6432

Provider Enumeration Date	:	07/01/2016
Last Update Date	:	07/01/2016

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