Individual
COLLEEN A. PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
6124 W PARKER RD, SUITE 536, PLANO, TX 75093-8122
(972) 943-8440
(972) 943-8348
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2213
(214) 231-2170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00932
TX
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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