Individual
DENISA KAVIKOVA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
821 N COLEMAN ST STE 100, PROSPER, TX 75078-2304
(972) 469-2626
Mailing address
821 N COLEMAN ST STE 100, PROSPER, TX 75078-2304
(972) 469-2626
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA08261
TX
363AS0400X
Surgical Physician Assistant
PA08261
TX
Other
Enumeration date
01/10/2013
Last updated
07/08/2025
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