Individual
LI SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5939 HARRY HINES BLVD SUIT 925, DALLAS, TX 75390
(214) 645-2870
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
Q5100
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2012
Last updated
05/30/2019
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