Basic Information
| Provider Information | |||||||||
| NPI: | 1982692430 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLATT | ||||||||
| FirstName: | MELVIN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8440 WALNUT HILL LANE | ||||||||
| Address2: | SUITE 700 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752313824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143613300 | ||||||||
| FaxNumber: | 2143613431 | ||||||||
| Practice Location | |||||||||
| Address1: | 8440 WALNUT HILL LANE | ||||||||
| Address2: | SUITE 700 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752313824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143613300 | ||||||||
| FaxNumber: | 2143613431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2005 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | D2560 | TX | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 123708306 | 05 | TX | MEDICAID |