Organization
QUUXX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK VANDER MEIDEN (PRESIDENT)
(214) 728-5067
Entity
Organization
Contact information
Practice address
6651 BLACKJACK OAKS RD, AUBREY, TX 76227-3609
(214) 794-8006
Mailing address
6651 BLACKJACK OAKS RD, AUBREY, TX 76227-3609
(214) 794-8006
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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