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Individual

MICHAEL LALLI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
NNP

Contact information

Practice address
1303 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 882-2892
(817) 882-5335
Mailing address
3606 BLUEBONNET CIR, WEATHERFORD, TX 76087-9358
(817) 596-4477

Taxonomy

Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
458242
TX

Other

Enumeration date
04/19/2006
Last updated
07/08/2007
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