Provider Demographics
NPI:1215420575
Name:LIFETALK RESOURCE CENTER
Entity type:Organization
Organization Name:LIFETALK RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:P
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-387-8763
Mailing Address - Street 1:8380 WARREN PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4271
Mailing Address - Country:US
Mailing Address - Phone:385-214-6236
Mailing Address - Fax:
Practice Address - Street 1:8380 WARREN PKWY STE 204
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4271
Practice Address - Country:US
Practice Address - Phone:214-618-9352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable