Organization
D MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALENCIA JOHNSON (ASST OFFICE ADMINISTRATOR)
(972) 701-0199
Entity
Organization
Contact information
Practice address
4431 W WALNUT ST, GARLAND, TX 75042-4107
(972) 272-1880
(972) 276-1886
Mailing address
12200 PARK CENTRAL DR STE 100, DALLAS, TX 75251-2124
(972) 701-0199
(972) 701-0201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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