Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Dec 18, 2018
License(s)
PA12337 (TX), PA12337 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1430 EMPIRE CENTRAL DR | Dallas, TX 75247-4032 | |
| LOCATION | 1430 EMPIRE CENTRAL DR | Dallas, TX 75247-4032 | 214-645-8500 |
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