Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 23, 2007
License(s)
203681 (LA), M6486 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 678253 | Dallas, TX 75267-8253 | 800-841-4236 |
| LOCATION | 3500 GASTON AVE | Dallas, TX 75246-2017 | 800-841-4236 |
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