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1101 S Broadway St Ste 260 Carrollton TX 75006-7277 | |
(972) 625-2631 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 1101 S Broadway St Ste 260, Carrollton, Texas |
Authorized Official Name and Position | Teresa Masdon (FOUNDER/DIRECTOR) |
Authorized Official Contact | 9726252631 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1101 S Broadway St Ste 260 Carrollton TX 75006-7277 Ph: () - | 1101 S Broadway St Ste 260 Carrollton TX 75006-7277 Ph: (972) 625-2631 |
NPI Number | 1083983464 |
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Provider Enumeration Date | 12/14/2011 |
Last Update Date | 12/14/2011 |
Identifier | Type | State | Issuer |
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1083983464 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 201026 (Texas) | Primary |
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