MEDICARE: ECHAD MD SERVICES 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	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1629735501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECHAD MD SERVICES PLLC

Provider Business Mailing Address
First Line	:	5955 ALPHA RD # 1293
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-1121
Country	:	US
Telephone Number	:	972-999-1659
Fax Number	:	205-729-5887

Provider Business Practice Location Address
First Line	:	5955 ALPHA RD # 1293
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-1121
Country	:	US
Telephone Number	:	972-999-1659
Fax Number	:	205-729-5887

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MR. DAVID CLARK
Credential	:
Telephone Number	:	972-999-1659

Provider Enumeration Date	:	11/26/2021
Last Update Date	:	11/26/2021

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Directions to “ECHAD MD SERVICES PLLC ” Practice Location

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