| Dsa108 Llc | |
|
108 San Gabriel Dr Irving TX 75039-3350 | |
| (214) 620-7444 | |
| Not Available |
| Full Name | Dsa108 Llc |
|---|---|
| Speciality | General Practice |
| Location | 108 San Gabriel Dr, Irving, Texas |
| Authorized Official Name and Position | Prabhav Tella (OWNER) |
| Authorized Official Contact | 2146207444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dsa108 Llc 825 W Royal Ln Ste 230 Irving TX 75039-3601 Ph: (214) 620-7444 | Dsa108 Llc 108 San Gabriel Dr Irving TX 75039-3350 Ph: (214) 620-7444 |
| NPI Number | 1710374046 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 04/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710374046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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