| Koala Center For Sleep Disorders Tx-1 | |
|
4927 Lake Ridge Pkwy Suite 140 Grand Prairie TX 75052-3087 | |
| (817) 913-3537 | |
| Not Available |
| Full Name | Koala Center For Sleep Disorders Tx-1 |
|---|---|
| Speciality | Dentist |
| Location | 4927 Lake Ridge Pkwy, Grand Prairie, Texas |
| Authorized Official Name and Position | Derrick Taylor (OFFICE MANAGER/CO-OWNER) |
| Authorized Official Contact | 8179133537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koala Center For Sleep Disorders Tx-1 4927 Lake Ridge Pkwy Suite 140 Grand Prairie TX 75052-3087 Ph: () - | Koala Center For Sleep Disorders Tx-1 4927 Lake Ridge Pkwy Suite 140 Grand Prairie TX 75052-3087 Ph: (817) 913-3537 |
| NPI Number | 1205211174 |
|---|---|
| Provider Enumeration Date | 07/21/2015 |
| Last Update Date | 12/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205211174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 18732 (Texas) | Primary |
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