Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Oct 23, 2006
License(s)
R8853 (TX), A90996 (CA), 66308 (CT)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2825 OAK LAWN AVE UNIT 192749 | Dallas, TX 75219-4688 | 844-389-5711 |
| MAILING | 2825 OAK LAWN AVE UNIT 192749 | Dallas, TX 75219-4688 | 844-389-5711 |
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