Individual
SKYLAR WALLETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 LOMO ALTO DR, DALLAS, TX 75225-6530
(469) 766-7586
Mailing address
3227 MCKINNEY AVE, DALLAS, TX 75204-7424
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZGP819253067
BLUECROSS BLUESHIELD
TX
Enumeration date
06/13/2019
Last updated
06/13/2019
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