Provider Demographics
NPI:1689356586
Name:ORTHOPAEDIC SPECIALISTS OF DALLAS, PA
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPECIALISTS OF DALLAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ADRIA
Authorized Official - Last Name:PODINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-771-4400
Mailing Address - Street 1:1301 SUMMER LEE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5452
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2732
Practice Address - Country:US
Practice Address - Phone:972-771-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty