Provider Demographics
NPI: | 1396274676 |
---|---|
Name: | INDEPENDENT PHYSICIANS NETWORK PLLC |
Entity type: | Organization |
Organization Name: | INDEPENDENT PHYSICIANS NETWORK PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHAIRMAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | CHARLES |
Authorized Official - Last Name: | HALDEMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 214-252-3500 |
Mailing Address - Street 1: | PO BOX 650823 DEPT 41907 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75265-0823 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-411-7515 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3625 N HALL ST # 800 |
Practice Address - Street 2: | |
Practice Address - City: | DALLAS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75219-5106 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-252-3500 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | METROPOLITAN ANESTHESIA CONSULTANTS, LLP |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2017-06-08 |
Last Update Date: | 2023-05-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty |