Individual
TERESA MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
6201 HARRY HINES BLVD, DALLAS, TX 75390-2571
(214) 633-5555
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(214) 633-5555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP126721
TX
Other
Enumeration date
10/31/2014
Last updated
08/19/2019
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