Provider Demographics
NPI:1912228545
Name:INJURY MEDICAL DOCTORS, PLLC
Entity Type:Organization
Organization Name:INJURY MEDICAL DOCTORS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-361-2772
Mailing Address - Street 1:8215 WESTCHESTER DR
Mailing Address - Street 2:SUITE 221
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6103
Mailing Address - Country:US
Mailing Address - Phone:214-361-2772
Mailing Address - Fax:
Practice Address - Street 1:8215 WESTCHESTER DR
Practice Address - Street 2:SUITE 221
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6103
Practice Address - Country:US
Practice Address - Phone:214-361-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11320111N00000X
TX4873207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty