Individual
JOSEPHINE DEVADOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2665 VILLA CREEK DR, STE 205A, DALLAS, TX 75234-7337
(469) 278-3736
(972) 499-9009
Mailing address
2665 VILLA CREEK DR STE 205A, DALLAS, TX 75234-7337
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10547491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10547491
DRIVER LICENCE
TX
Enumeration date
10/11/2021
Last updated
10/27/2021
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