Provider Demographics
NPI:1477529352
Name:RESIDENTIAL VISITS ASSOCIATION
Entity Type:Organization
Organization Name:RESIDENTIAL VISITS ASSOCIATION
Other - Org Name:DR'S HOME VISITS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-750-3714
Mailing Address - Street 1:5461A LA SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4107
Mailing Address - Country:US
Mailing Address - Phone:214-750-3714
Mailing Address - Fax:214-348-0129
Practice Address - Street 1:9696 SKILLMAN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8253
Practice Address - Country:US
Practice Address - Phone:214-348-7611
Practice Address - Fax:214-348-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00612NMedicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER