| Living Well Dallas, Inc. | |
|
17000 Preston Rd Ste 400 Dallas TX 75248-1201 | |
| (972) 930-0260 | |
| (972) 559-3648 |
| Full Name | Living Well Dallas, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 17000 Preston Rd Ste 400, Dallas, Texas |
| Authorized Official Name and Position | Betty Murray (CEO) |
| Authorized Official Contact | 9729300260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Well Dallas, Inc. 17000 Preston Rd Ste 400 Dallas TX 75248-1201 Ph: (972) 930-0260 | Living Well Dallas, Inc. 17000 Preston Rd Ste 400 Dallas TX 75248-1201 Ph: (972) 930-0260 |
| NPI Number | 1902951221 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 5496181570 |
|---|---|
| Medicare Enrollment ID | O20200210000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902951221 | NPI | - | NPPES |
| Provider Name | Bryan P Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013965045 PECOS PAC ID: 8820021488 Enrollment ID: I20090122000734 |
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