Individual
TONY PHANSANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST/FA
Contact information
Practice address
9156 BROOK HILL LN, FORT WORTH, TX 76244-4930
(817) 726-7644
Mailing address
9156 BROOK HILL LN, FORT WORTH, TX 76244-4930
(817) 726-7644
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
129282
TX
Other
Enumeration date
09/06/2011
Last updated
02/26/2012
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