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Individual

ANGELA D BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24060 FM 15, TROUP, TX 75789-5510
(903) 521-1564
Mailing address
24060 FM 15, TROUP, TX 75789-5510

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
702913
TX

Other

Enumeration date
07/08/2020
Last updated
07/08/2020
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