629 Twelve Oaks. LLC
Specialist/Technologist, Other, Surgical Technologist in Dallas, TX. Organization (NPI-2).
NPI number1568844751
StatusActive
Last updated in NPPESJun 24, 2015
Details
- NPI
- 1568844751
- Entity type
- Organization (NPI-2)
- Legal business name
- 629 Twelve Oaks. LLC
- Organization subpart
- No
- Enumeration date
- Jun 24, 2015
- Last updated
- Jun 24, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZS0410X | Specialist/Technologist, Other, Surgical Technologist | – | – | Yes |
Practice location
4516 Lovers LnSt 331
Dallas, TX 75225-6925
Phone 214-315-6432 · Fax 214-317-4667
Mailing address
4516 Lovers LnSt 331
Dallas, TX 75225-6925
Phone 214-315-6432 · Fax 214-317-4667
Authorized official
Bridget Brady
Owner
2143156432
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