Individual
SAMUEL S FASANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A&S SMOOTHRIDE,LLC
Contact information
Practice address
6653 MCKINNEY RANCH PKWY APT 12208, MCKINNEY, TX 75070-2225
(773) 679-1137
Mailing address
3001 S HARDIN BLVD STE 110-314, MCKINNEY, TX 75070-7736
(469) 782-8220
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
802715611
TX
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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