Individual
DR. ITALA MANOSHA WICKREMASINGHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(214) 857-1757
Mailing address
8631 CLOVER MEADOW DR, DALLAS, TX 75243-7626
(214) 553-9118
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
92490
CA
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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