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Individual

MR. JOHN MAKINDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DHSC, PAC

Contact information

Practice address
4500 S LANCASTER RD # 112A DEPT, DALLAS, TX 75216-7167
(214) 857-1817
(214) 302-1306
Mailing address
PO BOX 171692, ARLINGTON, TX 76003-1692
(817) 874-3329

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA06021
LICENSE
TX
Enumeration date
08/30/2006
Last updated
01/14/2010
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