BRUCE E WHITEHEAD, MD, PA
Ambulatory Health at Merit Dr, Dallas, TX

License number
Texas J4610
Category
Ambulatory Health
Type
Health Service
Owner
Name: MARK A REYNOLDS, CMM
Title: PRACTICE MANAGER
Phone: (214) 294-8989
Address
Address
12201 Merit Dr SUITE 300, Dallas, TX 75251
National Provider ID: 1114300795
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BRUCE E. WHITEHEAD, M.D., PA

12201 Merit Dr STE 300, Dallas, TX 75251

Doing business as:
Bruce E. Whitehead, M.D., PA
Registration:
Oct 30, 2014
State ID:
0802093776
Business type:
Professional Association
Director, Member:
Bruce E. Whitehead (Director, Member)
Agent:
Bruce E Whitehead,2 Frst Plz 12201 Merit Dr, Dallas, TX 75251 (Physical)
TIN:
32055586641

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