Provider Demographics
NPI:1124342811
Name:MTS HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MTS HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:CASAD
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-526-5247
Mailing Address - Street 1:6611 HILLCREST AVE # 435
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1301
Mailing Address - Country:US
Mailing Address - Phone:214-526-5247
Mailing Address - Fax:214-369-9291
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-8430
Practice Address - Fax:214-369-9291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3219207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty