Provider Demographics
NPI:1528397387
Name:UPTOWN INFUSION CENTER PA
Entity Type:Organization
Organization Name:UPTOWN INFUSION CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-303-1033
Mailing Address - Street 1:2929 CARLISLE ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1084
Mailing Address - Country:US
Mailing Address - Phone:214-303-1033
Mailing Address - Fax:214-303-1032
Practice Address - Street 1:2929 CARLISLE ST
Practice Address - Street 2:SUITE 260
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1084
Practice Address - Country:US
Practice Address - Phone:214-303-1033
Practice Address - Fax:214-303-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy