Southern Belle Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

L9399 Issued in TX

Legal business name

SOUTHERN BELLE GROUP INC

Practice address

9304 Forest LN
Dallas, TX 75243-6238

Phone

(214) 937-1154

NPI assigned

Nov 11, 2010

Organization subpart

No

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

Authorized official

Name

Jason Nordstrom

Title

Ceo

Phone

(214) 937-1154

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1679874333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436238",
            "telephone_number": "214-937-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9304 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752436238",
            "telephone_number": "214-937-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BELLE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "NORDSTROM",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-937-1154"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L9399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.