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Individual

DR. MICHELA CARUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4700 N GALLOWAY AVE, MESQUITE, TX 75150-1516
(972) 686-6411
(972) 686-0594
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
K8721
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105721801
TX
05
105721802
TX
05
105721803
TX
05
105721804
TX
05
105721805
TX
01
8R1405
BLUE CROSS OF TEXAS
TX
Enumeration date
06/03/2006
Last updated
04/10/2017
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