Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Life Span Medicine PA

Organization General Practice Physician · NPI 1679514632

Life Span Medicine PA provides General Practice Physician services in Dallas, Texas. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2706 Fairmont St
Dallas, TX 75201 Not confirmed with CMS for 16 years — call before visiting
Phone: (214) 303-1888
Fax: (214) 303-1550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1679514632
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Renna — Ceo · (214) 303-1888
NPI enumeratedJune 9, 2006
Last updated in NPPESApril 7, 2010
Mailing address2706 Fairmont Street, Dallas, TX 75201

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