| Healthsource Of Highland Park | |
|
3408 Milton Ave, Dallas, TX 75205-1338 | |
| (214) 739-2225 | |
| (214) 739-2228 |
| Full Name | Healthsource Of Highland Park |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Rehabilitation |
| Location | 3408 Milton Ave, Dallas, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114160827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NR0400X | Chiropractor - Rehabilitation | 09289 (Texas) | Primary |
| Provider Name | Robert T Petersen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811917172 PECOS PAC ID: 6406930759 Enrollment ID: I20080225000633 |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of Highland Park 3408 Milton Ave, Dallas, TX 75205-1338 Ph: (214) 739-2225 | Healthsource Of Highland Park 3408 Milton Ave, Dallas, TX 75205-1338 Ph: (214) 739-2225 |
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