Organization
EQUILYST LLC.
Active
Organization
EQUILYST LLC.
Active
Other names
EQUILYST MODERN MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM BLAKE YORK FNP-C (MANAGING MEMBER)
(337) 580-0710
Entity
Organization
Contact information
Practice address
2909 CANTON ST STE C, DALLAS, TX 75226-3508
(214) 984-3696
(469) 523-5503
Mailing address
3131 MAIN ST APT 122, DALLAS, TX 75226-1530
(337) 580-0710
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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