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NPI Code Detail

MEDICARE: SALLY PURCELL DVM

MEDICARE: SALLY PURCELL DVM
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
1207R00000XInternal Medicine Physician10748TX

General Provider Information

NPI Number : 1720693708
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY PURCELL DVM
Provider Business Mailing Address
First Line : 6150 E MOCKINGBIRD LN
Second Line :
City : DALLAS
State : TX
Zip : 75214-2601
Country : US
Telephone Number : 214-828-5800
Fax Number : 469-334-0230
Provider Business Practice Location Address
First Line : 6150 E MOCKINGBIRD LN
Second Line :
City : DALLAS
State : TX
Zip : 75214-2601
Country : US
Telephone Number : 214-828-5800
Fax Number : 469-334-0230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2020
Last Update Date : 09/15/2020

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