FOUNTAIN LIFE DALLAS, LLC is a clinic center in The Colony, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FOUNTAIN LIFE DALLAS, LLC NPI is 1336829514. The provider is registered as an organization entity type.
The provider's business location address is:
5762 GRANDSCAPE BLVD STE 115
THE COLONY, TX
ZIP 75056-782
Phone: (469) 669-0336
The provider's authorized official is Barbara Woo .
The authorized official title is Director Of Clinical Operations and has the following contact phone number (917) 810-8672.
The CLIA number assigned to this NPI record is 10D2274017 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/21/2023 and was last updated on 7/21/2023.