MEDICARE: HAPOEL DALLAS, PLLC

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	246ZS0410X	Surgical Technologist

General Provider Information

NPI Number	:	1366791436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAPOEL DALLAS, PLLC

Provider Business Mailing Address
First Line	:	7777 FOREST LN STE CA94
Second Line	:	PMB #155
City	:	DALLAS
State	:	TX
Zip	:	75230-7513
Country	:	US
Telephone Number	:	214-317-4666
Fax Number	:	214-317-4667

Provider Business Practice Location Address
First Line	:	7777 FOREST LN STE CA94
Second Line	:	PMB #155
City	:	DALLAS
State	:	TX
Zip	:	75230-7513
Country	:	US
Telephone Number	:	214-317-4666
Fax Number	:	214-317-4667

Authorized Official
Title or Position	:	OWNER
Name	:	YOAV HAHN
Credential	:	MD
Telephone Number	:	214-317-4666

Provider Enumeration Date	:	09/05/2012
Last Update Date	:	09/05/2012

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