Individual
SAMANTHA RAE KILLGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-AC
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-2331
Mailing address
3300 DISCOVERY DR, LITTLE ELM, TX 75068-0710
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP140648
TX
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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