| Injury 1 Of Dallas | |
|
9262 Forest Ln Suite 100 Dallas TX 75243-4207 | |
| (241) 692-5001 | |
| (214) 692-5750 |
| Full Name | Injury 1 Of Dallas |
|---|---|
| Speciality | Psychologist |
| Location | 9262 Forest Ln, Dallas, Texas |
| Authorized Official Name and Position | Nat Mangum (CEO) |
| Authorized Official Contact | 4696886628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Injury 1 Of Dallas 5931 Desco Dr Dallas TX 75225-1604 Ph: (214) 563-5122 | Injury 1 Of Dallas 9262 Forest Ln Suite 100 Dallas TX 75243-4207 Ph: (241) 692-5001 |
| NPI Number | 1831245364 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 03/26/2010 |
| Medicare PECOS PAC ID | 5890715080 |
|---|---|
| Medicare Enrollment ID | O20051202000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831245364 | NPI | - | NPPES |
| Provider Name | Desiree W Kilcrease Fleming |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043211774 PECOS PAC ID: 2466492244 Enrollment ID: I20131231001105 |
| Provider Name | Nicole M Mangum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790727451 PECOS PAC ID: 7416131099 Enrollment ID: I20150211000744 |
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