| Silverlake Professional Group | |
|
2104 Kimball Hill Ct Southlake TX 76092-7914 | |
| (432) 352-4443 | |
| Not Available |
| Full Name | Silverlake Professional Group |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 2104 Kimball Hill Ct, Southlake, Texas |
| Authorized Official Name and Position | Philip Talley (OWNER) |
| Authorized Official Contact | 3235244434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Silverlake Professional Group 2104 Kimball Hill Ct Southlake TX 76092-7914 Ph: (432) 352-4443 | Silverlake Professional Group 2104 Kimball Hill Ct Southlake TX 76092-7914 Ph: (432) 352-4443 |
| NPI Number | 1861100976 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 11/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861100976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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