Basic Information
| Provider Information | |||||||||
| NPI: | 1023338142 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | METDALSPI, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17101 DALLAS PARKWAY | ||||||||
| Address2: | |||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750017103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4692483900 | ||||||||
| FaxNumber: | 4692483901 | ||||||||
| Practice Location | |||||||||
| Address1: | 17101 DALLAS PARKWAY | ||||||||
| Address2: | |||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750017103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4692483900 | ||||||||
| FaxNumber: | 4692483901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2010 | ||||||||
| LastUpdateDate: | 05/20/2020 | ||||||||
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| AuthorizedOfficialLastName: | TASSET | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE CHAIR, NUEHEALTH | ||||||||
| AuthorizedOfficialTelephone: | 9133870510 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 05/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.