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Organization
LAKE DALLAS FAMILY MEDICINE PLLC
Active
Organization
LAKE DALLAS FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN PHILLIPS WHITE FNP-BC (OWNER)
(214) 908-6012
Entity
Organization
Contact information
Practice address
503 MAIN ST STE C, LAKE DALLAS, TX 75065-2878
(940) 535-5296
(940) 535-5297
Mailing address
503 MAIN ST STE C, LAKE DALLAS, TX 75065-2878
(940) 535-5296
(940) 535-5297
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/03/2019
Last updated
06/19/2019
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