Provider Demographics
NPI:1831558972
Name:NORTH DALLAS LACTATION, LLC
Entity type:Organization
Organization Name:NORTH DALLAS LACTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMYLOU
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-734-6802
Mailing Address - Street 1:7760 ALTO CARO DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4304
Mailing Address - Country:US
Mailing Address - Phone:214-734-6802
Mailing Address - Fax:
Practice Address - Street 1:7760 ALTO CARO DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4304
Practice Address - Country:US
Practice Address - Phone:214-734-6802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty