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Individual

ELAINA NOEL RICCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7777 FOREST LN, SUITE C-755, DALLAS, TX 75230-2584
(972) 566-2600
(972) 566-2121
Mailing address
7777 FOREST LN, SUITE C-755, DALLAS, TX 75230-2584
(972) 566-2600
(972) 566-2121

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02436
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8N8201
BLUE CROSS
TX
Enumeration date
03/24/2006
Last updated
04/26/2011
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