Broadway, Dallas

Broadway, Dallas is an sole proprietor health care provider with primary practice located at 1010 Nw Loop 410 Ste 100B , San Antonio TX 78213-2220. He recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Ambulatory Surgical, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Broadway, Dallas can be contacted via phone (210) 465-7015.

Contact Information

Primary practice address
1010 Nw Loop 410 Ste 100B San Antonio TX 78213-2220
Phone: (210) 465-7015
Fax: (210) 465-7014
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 249640 New York
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 25MA09187400 New Jersey
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X P8223 Texas

Profile Details

NPI number 1366646416
LBN Legal business name Broadway, Dallas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2007
Last updated Nov 3rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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