Individual
DEXIE MALLARI VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5520 GRAYSON RIDGE DR, FT WORTH, TX 76179-7113
(305) 340-1424
Mailing address
5520 GRAYSON RIDGE DR, FT WORTH, TX 76179-7113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
964768
TX
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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