Registry details
Type
Organization
Primary specialty
Nurse Practitioner
Enumerated
Nov 19, 2019
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2100 VIRGINIA ST STE F | Grand Prairie, TX 75051-3796 | 214-862-5756 |
| MAILING | 1024 FAIR OAKS DR | Grand Prairie, TX 75052-2718 | 214-862-5756 |
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