1306890736 NPI number — ENDOCRINE ASSOCIATES OF DALLAS, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306890736 NPI number — ENDOCRINE ASSOCIATES OF DALLAS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENDOCRINE ASSOCIATES OF DALLAS, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306890736
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 678118
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75267-8118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-363-5535
Provider Business Mailing Address Fax Number:
214-368-2760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10260 N CENTRAL EXPY
Provider Second Line Business Practice Location Address:
SUITE 100N
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-3437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-363-5535
Provider Business Practice Location Address Fax Number:
214-368-2760
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SACHSON
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
214-363-5535

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Z000K5876 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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