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LIFE SPAN MEDICINE PA

General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

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Contact Information

LIFE SPAN MEDICINE PA
2706 FAIRMONT STREET
DALLAS, TX  75201
 Phone: 214-303-1888
 Fax: 214-303-1550
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

General Practice

 208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for LIFE SPAN MEDICINE PA

NPI # 1679514632
LBN Legal business name LIFE SPAN MEDICINE PA
Authorized official GINA RENNA - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/09/2006
Last updated 04/07/2010 - About 16 years ago
Identifiers
Other 0036HZ BLUE CROSS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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