Provider Demographics
NPI:1124155544
Name:HAND SURGERY OF DALLAS ASSN
Entity type:Organization
Organization Name:HAND SURGERY OF DALLAS ASSN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:DRIGGS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-902-1478
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-0580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5920 FOREST PARK RD
Practice Address - Street 2:SUITE 530
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6411
Practice Address - Country:US
Practice Address - Phone:972-991-4263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4306207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177542101Medicaid
TX0025KGOtherBCBS
TXD48252Medicare UPIN
TX0025KGOtherBCBS
TX4909980001Medicare NSC