Provider Demographics
NPI:1689085771
Name:GREATER DALLAS ORTHOPAEDICS, PLLC
Entity Type:Organization
Organization Name:GREATER DALLAS ORTHOPAEDICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLLABASHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-252-7020
Mailing Address - Street 1:12230 COIT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2322
Mailing Address - Country:US
Mailing Address - Phone:214-252-7020
Mailing Address - Fax:214-252-7025
Practice Address - Street 1:12230 COIT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2322
Practice Address - Country:US
Practice Address - Phone:214-252-7020
Practice Address - Fax:214-252-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty