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Organization
IMMANUEL FAMILY CLINIC PLLC
Active
Organization
IMMANUEL FAMILY CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUTHA M FERNANDO FNP (OWNER)
(214) 625-2808
Entity
Organization
Contact information
Practice address
2760 E TRINITY MILLS RD STE 115, CARROLLTON, TX 75006-2194
(469) 900-8211
Mailing address
2760 E TRINITY MILLS RD STE 115, CARROLLTON, TX 75006-2194
(469) 900-8211
(214) 617-0478
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/15/2020
Last updated
02/11/2020
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