Provider Demographics
NPI:1356903595
Name:DALLAS RHEUMATOLOGY PLLC
Entity type:Organization
Organization Name:DALLAS RHEUMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-780-1639
Mailing Address - Street 1:2008 E HEBRON PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1601
Mailing Address - Country:US
Mailing Address - Phone:972-626-3280
Mailing Address - Fax:972-692-7194
Practice Address - Street 1:2008 E HEBRON PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1601
Practice Address - Country:US
Practice Address - Phone:972-626-3280
Practice Address - Fax:972-692-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-08
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty