MEDICARE: NETWORK PROVIDER ASSOCIATES

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	1223G0001X	General Practice Dentistry	18458	TX

General Provider Information

NPI Number	:	1639255474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NETWORK PROVIDER ASSOCIATES

Provider Business Mailing Address
First Line	:	17300 DALLAS PKWY
Second Line	:	STE 1070
City	:	DALLAS
State	:	TX
Zip	:	75248-1145
Country	:	US
Telephone Number	:	972-755-0800
Fax Number	:	972-755-0890

Provider Business Practice Location Address
First Line	:	9550 FOREST LN
Second Line	:	SUITE 700
City	:	DALLAS
State	:	TX
Zip	:	75243-5905
Country	:	US
Telephone Number	:	214-348-5505
Fax Number	:	214-348-9363

Authorized Official
Title or Position	:	CIO
Name	:	JOHN EVERETT BALLARD
Credential	:
Telephone Number	:	972-755-0800

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	04/20/2009

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Directions to “NETWORK PROVIDER ASSOCIATES ” Practice Location

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