| Kokoro Body | |
|
14850 Montfort Dr Ste 181 Lb 11 Dallas TX 75254-1450 | |
| (469) 431-5656 | |
| (214) 446-6010 |
| Full Name | Kokoro Body |
|---|---|
| Speciality | Clinic/Center |
| Location | 14850 Montfort Dr Ste 181, Dallas, Texas |
| Authorized Official Name and Position | Adriane Alexander (MANAGING MEMBER) |
| Authorized Official Contact | 2145501469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kokoro Body 14850 Montfort Dr Ste 181 Lb 11 Dallas TX 75254-1450 Ph: (469) 431-5656 | Kokoro Body 14850 Montfort Dr Ste 181 Lb 11 Dallas TX 75254-1450 Ph: (469) 431-5656 |
| NPI Number | 1245712421 |
|---|---|
| Provider Enumeration Date | 09/04/2018 |
| Last Update Date | 02/13/2020 |
| Medicare PECOS PAC ID | 3072859008 |
|---|---|
| Medicare Enrollment ID | O20190114000260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245712421 | NPI | - | NPPES |
| Provider Name | Ronald A Lester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942229539 PECOS PAC ID: 7911978507 Enrollment ID: I20040805000874 |
| Provider Name | Hanhdung T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639238769 PECOS PAC ID: 1850305392 Enrollment ID: I20060203000344 |
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