| Dale G Swanholm Md Pa | |
|
2300 Highland Village Rd Ste#600 Highland Village TX 75077-7148 | |
| (972) 317-0331 | |
| (972) 317-3811 |
| Full Name | Dale G Swanholm Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2300 Highland Village Rd, Highland Village, Texas |
| Authorized Official Name and Position | Dale G Swanholm (OWNER) |
| Authorized Official Contact | 9723170331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dale G Swanholm Md Pa 2300 Highland Village Rd Ste#600 Highland Village TX 75077-7148 Ph: (972) 317-0331 | Dale G Swanholm Md Pa 2300 Highland Village Rd Ste#600 Highland Village TX 75077-7148 Ph: (972) 317-0331 |
| NPI Number | 1245569037 |
|---|---|
| Provider Enumeration Date | 12/08/2009 |
| Last Update Date | 04/21/2021 |
| Medicare PECOS PAC ID | 8729122916 |
|---|---|
| Medicare Enrollment ID | O20100226000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245569037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E5263 (Texas) | Primary |
| Provider Name | Dale G Swanholm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730187444 PECOS PAC ID: 7012051238 Enrollment ID: I20100225000366 |
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