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 is a General Practice Physician 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
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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