LIFERESTORE MD USA LLC (NPI# 1922542075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922542075 |
| Entity Type | Organization |
| Organization Name | LIFERESTORE MD USA LLC |
| Other Organization Name | LIFERESTORE MD USA LLC |
| Practice Address |
3910 Gaston Ave Ste 140 Dallas TX 75246-1523 |
| Practice Telephone | 2144948121 |
| Mailing Telephone | 2144948121 |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2020-04-01 |
| Authorized Official Name | DAVID AKINA (OWNER) |
| Authorized Official Telephone | 8084898900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI | 1922542075 | 01 |
| Other Name | Type Code |
|---|---|
| LIFERESTORE MD USA LLC | Doing Business As Name - Organization |
| Restore Doc MD USA LLC | Former Legal Business Name - Organization |
| RestoreDOC MD USA LLC | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5508 W Plano Pkwy Ste 100, Plano, TX 750934858 | 2144948121 | 9727070702 |
| Street Address |
3910 GASTON AVE STE 140 |
| City | DALLAS |
| State | TX |
| Zip Code | 75246-1523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396201356 | Roseann Estrada Mendoza | Nurse Practitioner | 3600 Gaston Ave., Barnett Tower, Suite 711, Dallas, TX 75246 | 2019-02-14 |
| 1033683701 | Marta Revilla-leon | Dentist | 3302 Gaston Avenue, College of Dentistry, Texas A&m Uni, Room 713, Dallas, TX 75246 | 2019-01-16 |
| 1912408170 | Liza Johannesson | Transplant Surgery | Baylor University Medical Center, 3410 Worth Street, Ste 950, Dallas, TX 75246 | 2018-02-23 |
| 1841710266 | Stephanie Chartier-plante | Student in an Organized Health Care Education/Training Program | 3501 Junius St, Jonsson Hospital, Dallas, TX 75246 | 2017-06-27 |
| 1528505096 | Adam Bohnenblust | Chiropractor | 411 N Washington Ave Ste 2200, Dallas, TX 75246 | 2017-01-23 |
| 1699121327 | Magnolia Pain Associates Pllc | Pain Medicine | 3801 Gaston Ave Ste 318- 320, Dallas, TX 75246 | 2016-05-12 |
| 1073969408 | Apurva Yeluru | Hospitalist | 3500 Gaston Ave Ste 550, Dallas, TX 75246 | 2016-05-04 |
| 1134580533 | Sp Alf Ops Co, LLC | Assisted Living Facility | 3922 Simpson Street, Dallas, TX 75246 | 2016-03-11 |
| 1386031185 | Lisa Voigt | Student in an Organized Health Care Education/Training Program | 3501 Junius Street, Dallas, TX 75246 | 2015-04-20 |
| 1891107843 | Jessica Shie | Internal Medicine | Baylor Scott & White - Hospital Medicine Dallas, 3600 Gaston Ave., Wadley #550, Dallas, TX 75246 | 2014-05-27 |
| Find all providers in zip 75246 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1194345959 | Medplus Physician Group Inc. | General Practice | 8585 N Stemmons Fwy Ste S-105, Dallas, TX 75247-3836 | 2020-04-22 |
| 1598397937 | Jennifer Renee Palomares | General Practice | 12221 Merit Dr Ste 350, Dallas, TX 75251-3233 | 2020-02-04 |
| 1902449333 | Strategic Binary Solutions LLC | General Practice | 13030 Audelia Rd, 2190, Dallas, TX 75243-2471 | 2019-10-17 |
| 1275996860 | Doorstep Procare Management LLC | General Practice | 12035 Shiloh Rd Ste 310, Dallas, TX 75228-1507 | 2016-03-31 |
| 1023490661 | Adjust Physical Medicine Pllc | General Practice | 13450 Inwood Rd Ste 100, Dallas, TX 75244-5324 | 2015-06-19 |
| 1679983480 | Nathaniel Ott | General Practice | 810 Turner Ave, Dallas, TX 75208-3737 | 2014-05-01 |
| 1720427057 | Merritt Bonar Teddlie | General Practice | 7830 Meadow Park Dr, 108, Dallas, TX 75230-4942 | 2013-06-20 |
| 1871833673 | Thomas Boone Fisher | General Practice | 6931 Azalea Ln, Dallas, TX 75230-3565 | 2013-02-15 |
| Find all providers in DALLAS | ||||
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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.