Ch Ga Southern Georgia Llc | |
4055 Valley View Ln Suite 400 Dallas TX 75244-5074 | |
(972) 715-3800 | |
(888) 722-4282 |
Full Name | Ch Ga Southern Georgia Llc |
---|---|
Speciality | Internal Medicine |
Location | 4055 Valley View Ln, Dallas, Texas |
Authorized Official Name and Position | Melissa M Cooke (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 9727153808 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Ch Ga Southern Georgia Llc 4055 Valley View Ln Suite 400 Dallas TX 75244-5074 Ph: (972) 715-3800 | Ch Ga Southern Georgia Llc 4055 Valley View Ln Suite 400 Dallas TX 75244-5074 Ph: (972) 715-3800 |
NPI Number | 1649670142 |
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Provider Enumeration Date | 09/03/2014 |
Last Update Date | 09/03/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649670142 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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