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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