MEDICARE: WHITE ROCK FAMILY HEALTH

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1649297649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE ROCK FAMILY HEALTH

Provider Business Mailing Address
First Line	:	9015 GARLAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3920
Country	:	US
Telephone Number	:	214-747-8800
Fax Number	:	214-747-8801

Provider Business Practice Location Address
First Line	:	9015 GARLAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3920
Country	:	US
Telephone Number	:	214-747-8800
Fax Number	:	214-747-8801

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANGEL SALAZAR
Credential	:	MD
Telephone Number	:	214-747-8800

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	07/13/2011

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Directions to “WHITE ROCK FAMILY HEALTH ” Practice Location

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