Individual
CLAIRE PROVENZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7777 FOREST LN STE C106, DALLAS, TX 75230-6831
(972) 566-5255
(972) 566-5236
Mailing address
7777 FOREST LN STE C106, DALLAS, TX 75230-6831
(972) 566-5255
(972) 566-5236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16456
TX
Other
Enumeration date
12/20/2022
Last updated
03/01/2023
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