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Individual

ALICE SUNNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, WISH TUBAL CLINIC, DALLAS, TX 75235-7708
(214) 590-5306
(214) 590-2798
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
427573
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041550702
TX
05
041550703
TX
05
041550704
TX
05
041550705
TX
05
041550706
TX
05
041550707
TX
05
041550708
TX
05
041550709
TX
05
041550710
TX
05
041550711
TX
05
041550712
TX
01
8Y2985
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2006
Last updated
03/12/2009
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