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Organization
POTTERS HOUSE FAMILY CLINIC LLC
Active
Organization
POTTERS HOUSE FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMMACULATA INYANG FNP (CEO)
(214) 607-3650
Entity
Organization
Contact information
Practice address
7125 MARVIN D LOVE FWY, STE 207, DALLAS, TX 75237-3175
(214) 607-3650
Mailing address
7125 MARVIN D LOVE FWY, STE 207, DALLAS, TX 75237-3175
(214) 607-3650
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
808591
TX
Other
Enumeration date
10/19/2012
Last updated
04/15/2013
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