Registry details
Type
Individual
Primary specialty
Anesthesiology, Pain Medicine
Enumerated
May 31, 2009
License(s)
P9994 (TX), 125-056323 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3453 SAINT FRANCIS AVE STE 100 | Dallas, TX 75228-6079 | 214-983-1787 |
| MAILING | 3453 SAINT FRANCIS AVE STE 100 | Dallas, TX 75228-6079 | 915-241-0997 |
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