Provider Demographics
NPI:1659987022
Name:SPECIALISTS IN GERIATRIC AND PALLIATIVE CARE MEDICINE PLLC
Entity Type:Organization
Organization Name:SPECIALISTS IN GERIATRIC AND PALLIATIVE CARE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAZEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AKBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-854-3546
Mailing Address - Street 1:8198 WALNUT HILL LANE
Mailing Address - Street 2:JACKSON BLDG SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8210 WALNUT HILL LN STE 310
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4419
Practice Address - Country:US
Practice Address - Phone:972-913-2850
Practice Address - Fax:972-913-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM7859OtherTEXAS MEDICAL LICENSE