Provider profile · NPI 1013303080

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Internal Medicine · Dallas, TX · NPI 1013303080 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Internal Medicine

Enumerated

Apr 7, 2015

License(s)

Addresses on file

PurposeAddressCity/StatePhone
MAILING1717 MAIN ST STE 5850 Dallas, TX 75201-7317972-449-0540
LOCATION1717 MAIN ST STE 5850 Dallas, TX 75201-7317972-449-0540

View on NPPES registry ↗

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