Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 15, 2007
License(s)
M5609 (TX), 036-114080 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5323 HARRY HINES BLVD | Dallas, TX 75390-7208 | 214-645-0624 |
| MAILING | PO BOX 845347 | Dallas, TX 75284-4011 | 214-645-0624 |
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