Individual
DANDREA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5225 N. LAMAR, AUSTIN, TX 78751-5665
(512) 483-5800
Mailing address
203 ADRIANA LN, HUTTO, TX 78634-5665
(512) 913-9809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
763654
TX
Other
Enumeration date
02/04/2016
Last updated
02/08/2016
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