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1629 W Hebron Pkwy, Carrollton, TX 75010-6334 | |
(972) 478-5538 | |
(972) 820-7177 |
Full Name | |
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Type | Facility |
Speciality | Physical Medicine & Rehabilitation - Pain Medicine |
Location | 1629 W Hebron Pkwy, Carrollton, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144760364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NR0400X | Chiropractor - Rehabilitation | 7350 (Texas) | Secondary |
2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Primary |
Provider Name | Timothy J Uselton |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1730117599 PECOS PAC ID: 9133203995 Enrollment ID: I20080303000775 |
Provider Name | Shukura B Leo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164786380 PECOS PAC ID: 5193992337 Enrollment ID: I20190725002154 |
Mailing Address | Practice Location Address |
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1629 W Hebron Pkwy, Carrollton, TX 75010-6334 Ph: (972) 478-5538 | 1629 W Hebron Pkwy, Carrollton, TX 75010-6334 Ph: (972) 478-5538 |