Provider Demographics
NPI:1679772917
Name:AUBURNDALE CORPORATION
Entity Type:Organization
Organization Name:AUBURNDALE CORPORATION
Other - Org Name:CORPORATE HEALTH MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-361-0995
Mailing Address - Street 1:7515 GREENVILLE AVE
Mailing Address - Street 2:SUITE 605
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3831
Mailing Address - Country:US
Mailing Address - Phone:214-361-0995
Mailing Address - Fax:214-361-0865
Practice Address - Street 1:7515 GREENVILLE AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3831
Practice Address - Country:US
Practice Address - Phone:214-361-0995
Practice Address - Fax:214-361-0865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1113174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty