Provider Demographics
NPI:1770014771
Name:DALLAS PULMONARY ASSOCIATES CRITICAL CARE
Entity Type:Organization
Organization Name:DALLAS PULMONARY ASSOCIATES CRITICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGACNP
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDOC
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:817-715-2810
Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:STE 845
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2363
Mailing Address - Country:US
Mailing Address - Phone:214-960-5681
Mailing Address - Fax:214-947-2727
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:STE 845
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-960-5681
Practice Address - Fax:214-947-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RP1001X282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX319227001Medicaid