Provider Demographics
NPI:1245255108
Name:DALLAS SERVICES
Entity type:Organization
Organization Name:DALLAS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:HELM
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-828-9900
Mailing Address - Street 1:5442 LA SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4108
Mailing Address - Country:US
Mailing Address - Phone:214-828-9900
Mailing Address - Fax:214-828-9901
Practice Address - Street 1:5442 LA SIERRA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4108
Practice Address - Country:US
Practice Address - Phone:214-828-9900
Practice Address - Fax:214-828-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5703T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX091737902Medicaid
TX00E36WMedicare ID - Type Unspecified
TXU75502Medicare UPIN