Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Dec 14, 2015
License(s)
PA10218 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2325 SAN GABRIEL DR | Plano, TX 75074-3464 | |
| LOCATION | 500 W MAIN ST | Lewisville, TX 75057-3641 | 972-420-1000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.