Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Nov 25, 2005
License(s)
K9472 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 660599 | Dallas, TX 75266-0599 | |
| LOCATION | 3310 LIVE OAK ST COOC FLOAT | Dallas, TX 75204-6153 | 214-266-1000 |
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