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Contact Information

SILVERLAKE PROFESSIONAL GROUP
2104 KIMBALL HILL CT
SOUTHLAKE, TX76092-7914
 Phone: 432-352-4443
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SILVERLAKE PROFESSIONAL GROUP

NPI Number 1861100976
LBN Legal business name SILVERLAKE PROFESSIONAL GROUP
Authorized official PHILIP TALLEY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2022
Last updated 11/08/2022 - About 4 years ago
Identifiers n/a
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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