Individual
DR. SHAYLA DEROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7708
(214) 645-0325
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0325
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1275891988
TX
207LP3000X
Pediatric Anesthesiology Physician
Primary
1275891988
TX
Other
Enumeration date
05/01/2012
Last updated
10/01/2017
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