Organization · NPI-2

Dallas Vascular Group, P.L.L.C

· Dallas, TX

NPI number1851638217
StatusActive
Last updated in NPPESApr 2, 2021

Details

NPI
1851638217
Entity type
Organization (NPI-2)
Legal business name
Dallas Vascular Group, P.L.L.C
Organization subpart
No
Enumeration date
Jan 4, 2013
Certification date
Apr 2, 2021
Last updated
Apr 2, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086S0129X ––Yes
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)––

Practice location

8210 Walnut Hill Ln Ste 505
Dallas, TX 75231-4420

Phone 214-345-4160 · Fax 214-345-4165

Mailing address

8210 Walnut Hill Ln Ste 505
Dallas, TX 75231-4420

Phone 214-345-4160 · Fax 214-345-4165

Authorized official

Russell C Lam
President
2143454160

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