Organization
ANNAM THE NINTH LP
Active
Organization
ANNAM THE NINTH LP
Active
Other names
MESQUITE MEDICAL AND COSMETIC DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
TINH LE DO (GENERAL PARTNER)
(816) 529-1525
Entity
Organization
Contact information
Practice address
2704 N GALLOWAY AVE STE 101, MESQUITE, TX 75150-6379
(972) 288-3376
(972) 288-3377
Mailing address
1324 N GALLOWAY AVE, SUITE 106, MESQUITE, TX 75149-2440
(816) 529-1525
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
N4546
TX
207R00000X
Internal Medicine Physician
N4546
TX
Other
Enumeration date
04/28/2014
Last updated
06/10/2020
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