Provider Demographics
NPI:1417571647
Name:MEDCARE-FATX-75248
Entity Type:Organization
Organization Name:MEDCARE-FATX-75248
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-792-0204
Mailing Address - Street 1:15110 DALLAS PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4601
Mailing Address - Country:US
Mailing Address - Phone:972-792-0204
Mailing Address - Fax:
Practice Address - Street 1:15110 DALLAS PKWY STE 102
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4601
Practice Address - Country:US
Practice Address - Phone:972-792-0204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty