MEDICARE: INFINITY PULMONARY SERVICES

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1750529046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY PULMONARY SERVICES

Provider Business Mailing Address
First Line	:	4907 SPRING AVE
Second Line	:	SUITE 207
City	:	DALLAS
State	:	TX
Zip	:	75210-1360
Country	:	US
Telephone Number	:	214-915-9916
Fax Number	:	214-915-9909

Provider Business Practice Location Address
First Line	:	4907 SPRING AVE
Second Line	:	SUITE 207
City	:	DALLAS
State	:	TX
Zip	:	75210-1360
Country	:	US
Telephone Number	:	214-915-9916
Fax Number	:	214-915-9909

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. DIANE JOYCE ALVARADO
Credential	:	BA,RRT
Telephone Number	:	214-915-9916

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	09/03/2010

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