Organization
THE IMG 365
Active
Other names
TheIMG365
Organization subpart
No
Provider details
NPI number
Authorized official
DESHONDA CHARTRICE TUCKER (OWNER)
(682) 351-7748
Entity
Organization
Contact information
Practice address
539 W COMMERCE ST # 5724, DALLAS, TX 75208-1953
(682) 352-7748
Mailing address
539 W COMMERCE ST # 5724, DALLAS, TX 75208-1953
(682) 352-7748
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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