Individual
ALICE FA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5757 WARREN PKWY STE 210, FRISCO, TX 75034-4777
(972) 731-6565
Mailing address
5115 AMBERGATE LN, DALLAS, TX 75287-5405
(214) 490-0980
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
T9102
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2018
Last updated
09/01/2022
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