Provider Demographics
NPI:1861038804
Name:TALL TREE SOLUTIONS PLLC
Entity Type:Organization
Organization Name:TALL TREE SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-768-6917
Mailing Address - Street 1:PO BOX 33066
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76162-3066
Mailing Address - Country:US
Mailing Address - Phone:281-346-3480
Mailing Address - Fax:281-462-4106
Practice Address - Street 1:220 O CONNOR RIDGE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6573
Practice Address - Country:US
Practice Address - Phone:214-560-2000
Practice Address - Fax:281-462-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty