| NPI Details | |
|---|---|
| NPI | 1467617316 |
| Enumeration Date | 07/21/2008 |
| Last Updated | 07/21/2008 |
| Entity Type | Healthcare Provider |
| Active | Over 8 years ago |
| Authorized Information | |
|---|---|
| Name | CHAD CHAD |
| Position | PRESIDENT |
| Phone | (817) 329-8500 |
| Fax | |
| Practice Location | |
|---|---|
| 2501 HERITAGE AVE GRAPEVINE TX, 76051-7037, US |
|
| Phone | (817) 329-8500 |
| Fax | |
| Business Location | |
|---|---|
| 545 E JOHN CARPENTER FWY IRVING TX, 75062-3931, US |
|
| Phone | (214) 239-8400 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 310400000X |
| License State | Texas |
| License Number | 101961 |
| Remove 1467617316 NPI Number | |
According to our database, Grapevine Autumn Leaves, Lp NPI is 1467617316, taxonomy code is 310400000X and license number is 101961, license state is located at Texas. Grapevine Autumn Leaves, Lp physically located at 2501 Heritage Ave, Grapevine TX, 76051-7037. NPI Number 1033115704 has the healthcare provider type.
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1467617316 NPI number is provided on an as is basis without warranty of any kind. 1467617316 is maintained by the National Plan & Provider Enumeration System. The contents of Grapevine Autumn Leaves, Lp are for informational purposes only.
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