Centerwell Senior Primary Care (tx) PA

NPI #1043964653 in Dallas, Texas

Provider Information

NPI Number: 1043964653
Entity Type: Organization
Organization Name: Centerwell Senior Primary Care (tx) PA
Subpart: Yes (part of a larger organization)
Parent Organization: CENTERWELL SENIOR PRIMARY CARE (TX) PA
Primary Specialty: Internal Medicine
Enumeration Date: Feb 11, 2022
Last Updated: Oct 18, 2022

Practice Location

Address: 3209 W CAMP WISDOM RD
City: Dallas
State: Texas
ZIP Code: 75237-2605
Phone: (469) 966-9660

Authorized Official

Name: ANGIE MARTINEZ
Title: SENIOR CREDENTIALING PROFESSIONAL
Phone: (407) 447-7120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
General Practice	208D00000X
Internal Medicine	207R00000X	Primary

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