| Dallas Lung Care | |
|
2504 Ridge Rd Ste 206 Rockwall TX 75087-2571 | |
| (304) 634-5523 | |
| Not Available |
| Full Name | Dallas Lung Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 2504 Ridge Rd Ste 206, Rockwall, Texas |
| Authorized Official Name and Position | Abdel Rahman Lataifeh (PHYSICIAN AND MANAGING MEMBER) |
| Authorized Official Contact | 2143047669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Lung Care 2504 Ridge Rd Ste 206 Rockwall TX 75087-2571 Ph: (214) 304-7669 | Dallas Lung Care 2504 Ridge Rd Ste 206 Rockwall TX 75087-2571 Ph: (304) 634-5523 |
| NPI Number | 1346910379 |
|---|---|
| Provider Enumeration Date | 09/21/2021 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 8426441049 |
|---|---|
| Medicare Enrollment ID | O20220203000740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346910379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | (* (Not Available)) | Primary |
| Provider Name | Abdel Rahman Rm Lataifeh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003122441 PECOS PAC ID: 8820285984 Enrollment ID: I20190415001485 |
| Provider Name | Yasser Etman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295949980 PECOS PAC ID: 6204901937 Enrollment ID: I20200103001347 |
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