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CENTRUM MEDICAL GROUP PLLC NPI 1700539079


NPI Information

NPI: 1700539079
Provider Name: CENTRUM MEDICAL GROUP, PLLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 45D2251741

Address:
10455 N CENTRAL EXPY STE 110
DALLAS, TX
ZIP 75231
Phone: (800) 218-8989
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CENTRUM MEDICAL GROUP, PLLC is a general practice in Dallas, TX. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CENTRUM MEDICAL GROUP, PLLC NPI is 1700539079. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10455 N CENTRAL EXPY STE 110
DALLAS, TX
ZIP 75231-211
Phone: (800) 218-8989
Fax: (786) 558-0242

The provider's authorized official is Vanessa Victorero .
The authorized official title is Coo and has the following contact phone number (305) 266-2929.

The CLIA number assigned to this NPI record is 45D2251741 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/27/2022 and was last updated on 1/27/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.