DOUG CHISHOLM, LLC
Managed Care Organizations at Meadow Rd, Dallas, TX

License number
Texas 65003
Category
Managed Care Organizations
Type
Health Maintenance Organization
Owner
Name: DOUG CHISHOLM LPC-S
Title: OWNER
Phone: (972) 834-0770
Address
Address
8350 Meadow Rd STE 198, Dallas, TX 75231
National Provider ID: 1902274012
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DOUG CHISHOLM, LLC

Dallas, TX

Doing business as:
Doug Chisholm, LLC
Registration:
Feb 21, 2013
Addresses:
8350 Mdw Rd, Dallas, TX 75231 (Mailing)
6600 Lyndon B Johnson Fwy, Dallas, TX 75240
State ID:
0801739549
Business type:
Domestic Limited Liability Company (LLC)
Members:
Douglas S Chishlolm (DIRECTOR, Director, President, Secretary), 8350 Mdw Rd, Dallas, TX 75231,Doug S. Chisholm Member, inactive
Agent:
Doug S Chisholm,6600 Lbj Fwy, Dallas, TX 75240 (Physical)
TIN:
32050265126

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