Organization
PRUDENTIAL MEDICAL NETWORK, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY DEAN SANDERS OPA-C (CO PRESIDENT)
(817) 714-9066
Entity
Organization
Contact information
Practice address
5455 HONEYSUCKLE RD, MIDLOTHIAN, TX 76065-7006
(972) 567-9571
(817) 563-6934
Mailing address
5455 HONEYSUCKLE RD, MIDLOTHIAN, TX 76065-7006
(972) 567-9571
(817) 563-6934
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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