Individual
DEDRA SHATIA STUKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N HENDERSON AVE APT 201, DALLAS, TX 75214
(833) 336-6002
Mailing address
539 W COMMERCE ST # 4922, DALLAS, TX 75208-1953
(833) 336-6002
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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