Organization
MODERN MALE T-CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALVATORE CAMPO (OWNER)
(800) 246-5698
Entity
Organization
Contact information
Practice address
15340 DALLAS PKWY, STE2400, DALLAS, TX 75248-4636
(800) 246-5698
Mailing address
15340 DALLAS PKWY, STE2400, DALLAS, TX 75248-4636
(800) 246-5698
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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