Individual
ANDREA NICOLE PENNINGTON-PEACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
1935 MEDIAL DISTRICT, DALLAS, TX 75235
(214) 456-2022
Mailing address
223 SANDY WAY, RED OAK, TX 75154-6550
(214) 704-5474
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
4694
TX
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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