Provider Demographics
NPI:1295769206
Name:DALLAS LUNG CONSULTANTS PA
Entity type:Organization
Organization Name:DALLAS LUNG CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-296-8888
Mailing Address - Street 1:2701 PRINCE GEORGE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2045
Mailing Address - Country:US
Mailing Address - Phone:972-296-8888
Mailing Address - Fax:972-780-9550
Practice Address - Street 1:2701 PRINCE GEORGE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2045
Practice Address - Country:US
Practice Address - Phone:972-296-8888
Practice Address - Fax:972-780-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1159174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084184301Medicaid
TXA01715Medicare UPIN
TX00N44JMedicare PIN
TX084184301Medicaid