Provider Demographics
NPI:1558567784
Name:DALLAS DOCTORS, PA
Entity Type:Organization
Organization Name:DALLAS DOCTORS, PA
Other - Org Name:LA PLAZA REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-352-3000
Mailing Address - Street 1:PO BOX 781667
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75378-1667
Mailing Address - Country:US
Mailing Address - Phone:214-352-3000
Mailing Address - Fax:214-358-2418
Practice Address - Street 1:2351 W NORTHWEST HWY
Practice Address - Street 2:SUITE 3100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4433
Practice Address - Country:US
Practice Address - Phone:214-352-3000
Practice Address - Fax:214-358-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5590111NX0100X
TXL8125207QS0010X
TX10555302251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty