Individual
CAITLYN GRACE CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3417 GASTON AVE STE 965, DALLAS, TX 75246-2036
(972) 817-6050
Mailing address
3417 GASTON AVE STE 965, DALLAS, TX 75246-2036
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17196
TX
Other
Enumeration date
08/01/2023
Last updated
01/09/2024
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