Unknown Individual – General Practice Physician, NPI 1417975723
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
9229, Lyndon B Johnson Freeway, Lake Highlands, Dallas, Dallas County, Texas, 75243, United States
SUITE 250
DALLAS, TX 752433405
Phone: (972) 739-3097
Fax: (972) 739-2673
Type: Mailing
1645, North Town East Boulevard, Mesquite, Dallas County, Texas, 75150, United States
SUITE 174
MESQUITE, TX 751504158
Phone: (972) 270-5549
Fax: (972) 270-5558
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75243)
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