Individual
RICARDO CHUJUTALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
4924 MARSH HARRIER AVE, GRAND PRAIRIE, TX 75052-3057
(972) 652-0705
(972) 752-7889
Mailing address
4924 MARSH HARRIER AVE, GRAND PRAIRIE, TX 75052-3057
(972) 652-0705
(972) 752-7889
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/12/2009
Last updated
03/26/2015
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