Life Span Medicine Pa

LBN: Life Span Medicine Pa
Life Span Medicine Pa is an health care organization with primary practice located at 2706 Fairmont Street , Dallas TX 75201. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. Life Span Medicine Pa can be contacted via phone (214) 303-1888, or through Renna, Gina via phone (214) 303-1888.

Contact Information

Primary practice address
2706 Fairmont Street Dallas TX 75201
Phone: (214) 303-1888
Fax: (214) 303-1550
Website:
Map and Directions
Authorized official contact:
Name: Renna, Gina
Phone: (214) 303-1888

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1679514632
LBN Legal business name Life Span Medicine Pa
DBA Doing business as
Authorized official Renna, Gina
Entity Organization
Organization subpart 1 No
Enumeration date Jun 9th, 2006
Last updated Apr 7th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679514632 NPPES
Other 0036HZ BLUE CROSS

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