MEDICARE: DALLAS MEDTEX LP

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1770682585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS MEDTEX LP

Provider Business Mailing Address
First Line	:	6363 FOREST PARK RD
Second Line	:	SUITE # 810
City	:	DALLAS
State	:	TX
Zip	:	75235-5479
Country	:	US
Telephone Number	:	214-631-3139
Fax Number	:	214-350-1155

Provider Business Practice Location Address
First Line	:	6363 FOREST PARK RD
Second Line	:	SUITE # 810
City	:	DALLAS
State	:	TX
Zip	:	75235-5479
Country	:	US
Telephone Number	:	214-631-3139
Fax Number	:	214-350-1155

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. WILLIAM A. ALOI
Credential	:
Telephone Number	:	214-631-3139

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	08/22/2020

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