Individual
LISE DORROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3249 CATHEDRAL DR, GRAND PRAIRIE, TX 75052-6492
(214) 793-8937
(972) 262-8803
Mailing address
3249 CATHEDRAL DR, GRAND PRAIRIE, TX 75052-6492
(214) 793-8937
(972) 262-8803
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
136152
TX
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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