Provider Demographics
NPI:1386265353
Name:COLLABORATIVE HEALTH GROUP, PLLC
Entity type:Organization
Organization Name:COLLABORATIVE HEALTH GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-886-2108
Mailing Address - Street 1:9301 N CENTRAL EXPY STE 685
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0816
Mailing Address - Country:US
Mailing Address - Phone:469-697-7300
Mailing Address - Fax:469-697-7302
Practice Address - Street 1:9301 N CENTRAL EXPY STE 685
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0816
Practice Address - Country:US
Practice Address - Phone:469-697-7300
Practice Address - Fax:469-697-7302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty