| Equilyst Llc. | |
|
2909 Canton St Ste C Dallas TX 75226-3508 | |
| (214) 984-3696 | |
| (469) 523-5503 |
| Full Name | Equilyst Llc. |
|---|---|
| Speciality | Clinic/center |
| Location | 2909 Canton St Ste C, Dallas, Texas |
| Authorized Official Name and Position | William Blake York (MANAGING MEMBER) |
| Authorized Official Contact | 3375800710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Equilyst Llc. 3131 Main St Apt 122 Dallas TX 75226-1530 Ph: (337) 580-0710 | Equilyst Llc. 2909 Canton St Ste C Dallas TX 75226-3508 Ph: (214) 984-3696 |
| NPI Number | 1679123632 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 09/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679123632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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