Individual
MR. JOHNNY RAY SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2632 BOWLING GREEN AVE, DALLAS, TX 75216-3236
(405) 473-7230
Mailing address
2632 BOWLING GREEN AVE, DALLAS, TX 75216-3236
(405) 473-7230
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/29/2013
Last updated
04/29/2013
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