Basic Information
| Provider Information | |||||||||
| NPI: | 1518476407 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DOCTX3 PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | DIRECT ORTHOPEDIC CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2805 DALLAS PKWY STE 640 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938724 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2419 W SOUTHLAKE BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760926718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178092660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2017 | ||||||||
| LastUpdateDate: | 09/24/2017 | ||||||||
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| AuthorizedOfficialLastName: | HASSINGER | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2149830303 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.