LIFE SPAN MEDICINE PA is a general practice in Dallas, TX. LIFE SPAN MEDICINE PA NPI is 1679514632. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
2706 FAIRMONT STREET
DALLAS, TX
ZIP 75201
Phone: (214) 303-1888
Fax: (214) 303-1550
The provider's authorized official is Gina Renna .
The authorized official title is Ceo and has the following contact phone number (214) 303-1888.
The CLIA number assigned to this NPI record is 45D0997769 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/9/2006 and was last updated on 4/7/2010.