Life Span Medicine PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LIFE SPAN MEDICINE PA

Practice address

2706 Fairmont Street
Dallas, TX 75201

Phone

(214) 303-1888

Fax

(214) 303-1550

NPI assigned

Jun 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gina Renna

Title

Ceo

Phone

(214) 303-1888

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1679514632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 FAIRMONT STREET",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 FAIRMONT STREET",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75201",
            "telephone_number": "214-303-1888",
            "fax_number": "214-303-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "RENNA",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-303-1888"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0036HZ",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Life Living Home Health Agency, LLC
• Life Point Healthcare Services of Texas
• Life Solutions Counseling and Family Therapy PLLC
• Life Solutions South Texas
• Life Span Home Health, LLC
• Life Support DME and Medical Supplies
• Lifecare Hospitals of North Texas LP
• Lifecare Pharmacy of Dallas LLC
• Lifecenter Skills for Development
• Lifegenix Med PLLC

• General Practice Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.