Individual
SHARON SAMUEL KORUTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-7000
Mailing address
2352 COMANCHE TRL, GRAND PRAIRIE, TX 75052-8595
(214) 893-5261
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP125521
TX
Other
Enumeration date
06/27/2014
Last updated
02/04/2016
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