Individual
MAGNOLIA WOODS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6130 W PARKER RD, PLANO, TX 75093-7901
(870) 413-1105
Mailing address
4932 CEDAR BRUSH DR, FORT WORTH, TX 76123-2957
(870) 413-0825
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
AP138502
TX
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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