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Organization

A PLATINUM FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS BROOKE CHEREE MCGOWAN (PRESIDENT)
18666746040
Entity
Organization

Contact information

Practice address
1921 WINDCHIME DR, DALLAS, TX 75224-4822
(186) 667-4604
Mailing address
1921 WINDCHIME DR, DALLAS, TX 75224-4822
(186) 667-4604

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
TX

Other

Enumeration date
12/06/2012
Last updated
12/06/2012
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