Individual
ESTINE MICHELLE MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 W IRVING BLVD, IRVING, TX 75060-2845
(870) 489-2692
Mailing address
621 GREEN MEADOWS LN, OVILLA, TX 75154-1474
(870) 489-2692
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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