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LIFE SPAN MEDICINE PA
NPI 1679514632
General Practice in Dallas, TX

Active since June 09, 2006
2706 FAIRMONT STREET, DALLAS, TX 75201(214) 303-1888(214) 303-1550 Get Directions Write a Review

NPPES record last updated: April 7, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Life Span Medicine Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE SPAN MEDICINE PA (NPI 1679514632) is a healthcare organization registered as a general practice in Dallas, Texas and active in the NPI registry since June 2006. The organization lists Gina Renna, Ceo, as its authorized official.

NPPES Registry Identity

NPI1679514632
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameLIFE SPAN MEDICINE PA
Location Address2706 FAIRMONT STREETDallas, TX 75201
Mailing Address2706 Fairmont StreetDallas, TX 75201
Phone(214) 303-1888
Fax(214) 303-1550
Organization SubpartNo
Authorized OfficialGina RennaCeo · (214) 303-1888
Enumeration DateJune 9, 2006
Last NPPES UpdateApril 7, 2010
✔ NPI 1679514632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
2706 FAIRMONT STREET, Dallas, TX 75201
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Other Identifiers 2

Other0036HZBlue Cross
Medicare UPIND97659

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Span Medicine PA's NPI number?

The NPI number for Life Span Medicine PA is 1679514632. It was assigned to this organization in the NPPES registry on June 9, 2006.

Where is Life Span Medicine PA located?

Life Span Medicine PA is located at 2706 Fairmont Street, Dallas, TX 75201. The listed phone number is (214) 303-1888.

What is Life Span Medicine PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Life Span Medicine PA was last updated on April 7, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.