Organization
KETAMINE CLINIC OF NORTH TEXAS, LLC
Active
Organization
KETAMINE CLINIC OF NORTH TEXAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN WAYNE CARRUTH MD (CO-OWNER)
(214) 929-9875
Entity
Organization
Contact information
Practice address
4100 FAIRWAY DR STE 200, CARROLLTON, TX 75010-6527
(214) 929-9875
Mailing address
4100 FAIRWAY DR STE 200, CARROLLTON, TX 75010-6527
(214) 929-9875
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F9284
TX
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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