Individual
VICTORY EZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2951 ARENOSO, GRAND PRAIRIE, TX 75054-0223
(817) 779-0493
Mailing address
2951 ARENOSO, GRAND PRAIRIE, TX 75054-0223
(817) 779-0493
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
BP10080732
TX
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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