institution
Life Span Medicine Pa
General Practice Physician in Dallas, Texas
NPI 1679514632

Life Span Medicine Pa is a General Practice Physician based in Dallas, TX. Life Span Medicine Pa practices in Dallas, TX. The NPI Number for Life Span Medicine Pa is 1679514632 and holds a License No. (Texas).

The current practice location address for Life Span Medicine Pa is 2706 Fairmont Street, Dallas, TX and can be reached out via phone at 214-303-1888 and via fax at 214-303-1550.

Location: 2706 Fairmont Street, Dallas, TX, 75201
institution
Provider Profile Details
NPI Number
1679514632
Provider Name
Life Span Medicine Pa
Credential
Provider Entity Type
Organization
Address
2706 Fairmont Street, Dallas, TX, 75201
Phone Number
214-303-1888
Fax Number
214-303-1550
Provider Enumeration Date
06/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0036HZ 01 BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
2706 Fairmont Street
City
State
Zip
75201
Phone Number
214-303-1888
Fax Number
214-303-1550
person
Provider Business Mailing Address Details
Address
2706 Fairmont Street
City
State
Zip
75201
Phone Number
214-303-1888
Fax Number
214-303-1550
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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