Individual
RALF WANCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1947 K AVE STE A400, PLANO, TX 75074-5943
(972) 535-5099
Mailing address
1411 N BECKLEY AVE STE 152, DALLAS, TX 75203-1586
(214) 948-7700
(214) 948-7701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019058471
TX
Other
Enumeration date
11/22/2019
Last updated
10/19/2020
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