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Organization

CHARLES LOVELACE DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES LOVELACE M.D (OWENER)
(972) 342-6265
Entity
Organization

Contact information

Practice address
1320 N GALLOWAY AVE STE 103, MESQUITE, TX 75149-2440
(972) 342-6265
(972) 437-0042
Mailing address
1320 N GALLOWAY AVE STE 103, MESQUITE, TX 75149-2440
(972) 342-6265
(972) 437-0042

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G9871
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1982771432
G9871 LIC
TX
Enumeration date
09/10/2012
Last updated
12/05/2019
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