Basic Information
Provider Information
NPI: 1932318615
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRICE
FirstName: ANGELA
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HUDSON
OtherFirstName: ANGELA
OtherMiddleName: PRICE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752847347
CountryCode: US
TelephoneNumber: 2146458000
FaxNumber: 2146457269
Practice Location
Address1: 5323 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 753907201
CountryCode: US
TelephoneNumber: 2146458000
FaxNumber: 2146457269
Other Information
ProviderEnumerationDate: 05/21/2007
LastUpdateDate: 04/03/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XN1078TXY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207R00000XN1078TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0005XN1078TXN Allopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist

No ID Information.


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