LIFE RESTORE MD (NPI# 1538615695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538615695 |
Entity Type | Organization |
Organization Name | LIFE RESTORE MD |
Practice Address |
3012 E Hebron Pkwy Suite 116 Carrollton TX 75010-4464 |
Practice Telephone | 2144447567 |
Mailing Telephone | 2144447567 |
Enumeration Date | 2016-08-29 |
Last Update Date | 2016-08-29 |
Authorized Official Name | JORGE N CHAVARRIA (OWNER) |
Authorized Official Telephone | 4695835807 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
Street Address |
3012 E HEBRON PKWY SUITE 116 |
City | CARROLLTON |
State | TX |
Zip Code | 75010-4464 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841228111 | Karen Elizabeth Allen | Optometrist | 3012 E Hebron Pkwy, Suite 100, Carrollton, TX 75010-4464 | 2006-06-28 |
1376080770 | Rebalance Wellness Centers | Surgery | 3012 E Hebron Pkwy, Suite 116, Carrollton, TX 75010-4464 | 2017-01-23 |
1033517958 | Matthew Tassinari | Physician Assistant | 3012 E Hebron Pkwy, Suite 116, Carrollton, TX 75010-4464 | 2014-12-09 |
1629207758 | Janna Eloise Burnett | Dentist | 3012 E Hebron Pkwy, Suite 108, Carrollton, TX 75010-4464 | 2009-07-10 |
1003053703 | Kenneth E. Baird, M.d., P.a. | Clinic/Center | 3012 E Hebron Pkwy, Ste 110, Carrollton, TX 75010-4464 | 2009-01-16 |
1679759856 | Mary Anne Peck, P. C. | Optometrist | 3012 E Hebron Pkwy, Suite 100, Carrollton, TX 75010-4428 | 2008-01-17 |
1821219031 | Debbie Garrett | Dental Hygienist | 3012 E Hebron Pkwy, Ste 108, Carrollton, TX 75010-4428 | 2007-05-02 |
1841411055 | Danielle Travalini | Dental Hygienist | 3012 E Hebron Pkwy, Ste 108, Carrollton, TX 75010-4428 | 2007-05-02 |
1003037177 | Eric Fox | Dental Hygienist | 3012 E Hebron Pkwy, Ste 108, Carrollton, TX 75010-4428 | 2007-05-02 |
1134344534 | Mark Barnett | Dentist | 3012 E Hebron Pkwy, #108, Carrollton, TX 75010 | 2007-04-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043782907 | Timothy C. Pringle Md Pa | Surgery | 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 | 2018-12-17 |
1184106411 | Cindy T Vu | Occupational Therapy Assistant | 1877 Cheyenne, Carrollton, TX 75010 | 2018-09-04 |
1639686256 | Little Lantern Hospice LLC | Hospice Care, Community Based | 4541 North Josey Lane, Suite 110-b, Carrollton, TX 75010 | 2018-01-04 |
1235681610 | Kahini Shah | Physical Therapist | 1012 W Hebron Pkwy Ste 124, Carrollton, TX 75010 | 2016-11-01 |
1881148849 | Wais Azesh | Dentist | 1233 Apache Lake Dr, Carrollton, TX 75010 | 2016-08-08 |
1225485055 | Julia Buckelew | Physical Therapist | 4100 Fairway Dr Ste 400, Carrollton, TX 75010 | 2016-05-23 |
1811355639 | Fastpass Ucc, Pllc | Clinic/Center | 4228 N Josey Ln Ste 150, Carrollton, TX 75010 | 2016-02-08 |
1326404393 | Miaojuan Li | Nurse Practitioner | 4100 Fairway Dr Ste 300, Carrollton, TX 75010 | 2016-01-06 |
1912376112 | Envoy Hospice North LLC | Hospice Care, Community Based | 4040 Tx-121, Carrollton, TX 75010 | 2015-09-17 |
1932593936 | Lifeway Hospice, LLC | Hospice Care, Community Based | 4040 State Highway 121, Suite 140, Carrollton, TX 75010 | 2015-03-27 |
Find all providers in zip 75010 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114409133 | Little Lantern Clinic LLC | General Practice | 4541 N Josey Ln Ste 110c, Carrollton, TX 75010-4614 | 2018-09-06 |
1396284600 | Rebalance Wellness Centers, LLC | General Practice | 3012 E Hebron Pkwy Ste 116, Carrollton, TX 75010-4461 | 2017-02-20 |
1831347020 | David Scott Miller | General Practice | 1465 Kingsridge Rd, Carrollton, KY 41008-8672 | 2008-09-03 |
1881691459 | Ronald Lewis Proctor | General Practice | 3740 N Josey Ln, Ste 121, Carrollton, TX 75007-2471 | 2005-06-28 |
1083198691 | Complete Family Wellness Pllc | General Practice | 4125 Fairway Dr Ste 190, Carrollton, TX 75010-6506 | 2018-09-19 |
1013394279 | Roger A. Schroeder Md Sc | General Practice | 727 9th St, Carrollton, IL 62016-1427 | 2015-04-27 |
1861628117 | Southern Medical Family Clinic, Inc. | General Practice | 1927 E Belt Line Rd Ste 146, Carrollton, TX 75006-5814 | 2009-06-01 |
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Find all providers with the same taxonomy |
City | CARROLLTON |
Zip Code | 75010 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.