Individual
SOWMYA RENUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BDS
Contact information
Practice address
4200 SOUTH FWY, FORT WORTH, TX 76115-1400
(309) 660-2120
Mailing address
735 COWBOYS PKWY APT 2099, IRVING, TX 75063-7733
(309) 660-2120
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
33666
TX
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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