Organization
MINIRTH CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKIE D GAGE (ADMINISTRATOR)
(972) 669-1733
Entity
Organization
Contact information
Practice address
1200 EAST COLLINS BLVD, SUITE #300, RICHARDSON, TX 75081
(972) 669-1733
(972) 669-1403
Mailing address
1200 EAST COLLINS BLVD, SUITE #300, RICHARDSON, TX 75081
(972) 669-1733
(972) 669-1403
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
08/22/2020
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