Provider Demographics
NPI:1255705109
Name:NEW YOU BARIATRIC CENTER, PA
Entity type:Organization
Organization Name:NEW YOU BARIATRIC CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:GRACE-JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-373-3183
Mailing Address - Street 1:8144 WALNUT HILL LN
Mailing Address - Street 2:STE 450
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4388
Mailing Address - Country:US
Mailing Address - Phone:214-373-3183
Mailing Address - Fax:214-361-5601
Practice Address - Street 1:7200 STATE HIGHWAY 161
Practice Address - Street 2:STE 120
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-4132
Practice Address - Country:US
Practice Address - Phone:214-838-7171
Practice Address - Fax:214-838-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty