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NPI Code Detail

MEDICARE: DALLAS NAVARRO HEALTHCARE SERVICES LLC

MEDICARE: DALLAS NAVARRO HEALTHCARE SERVICES LLC
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
1363L00000XNurse Practitioner245458TX

General Provider Information

NPI Number : 1801173786
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAS NAVARRO HEALTHCARE SERVICES LLC
Provider Business Mailing Address
First Line : 4432 MALCOLM X BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75215-4349
Country : US
Telephone Number : 214-428-2010
Fax Number :
Provider Business Practice Location Address
First Line : 4432 MALCOLM X BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75215-4349
Country : US
Telephone Number : 214-428-2010
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RUTH E GREER
Credential : RNCS
Telephone Number : 214-428-2010
Provider Enumeration Date : 11/07/2011
Last Update Date : 11/07/2011

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Directions to “DALLAS NAVARRO HEALTHCARE SERVICES LLC ” Practice Location

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