Provider Demographics
NPI:1871777029
Name:DFW LITHOTRIPSY, LLP
Entity type:Organization
Organization Name:DFW LITHOTRIPSY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER OF ABS
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-258-0326
Mailing Address - Street 1:6339 E SPEEDWAY BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1147
Mailing Address - Country:US
Mailing Address - Phone:520-323-8732
Mailing Address - Fax:520-547-1865
Practice Address - Street 1:5150 BROADWAY ST
Practice Address - Street 2:#189
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5710
Practice Address - Country:US
Practice Address - Phone:520-547-4130
Practice Address - Fax:520-258-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QL0400XAmbulatory Health Care FacilitiesClinic/CenterLithotripsy