Organization
MAGNOLIA DERMATOLOGY OF FRISCO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA A. GUSTOVICH MD (PRESIDENT)
(972) 668-3376
Entity
Organization
Contact information
Practice address
13192 DALLAS PKWY STE 620, FRISCO, TX 75033-4248
(972) 668-3376
(972) 668-7546
Mailing address
13192 DALLAS PKWY STE 620, FRISCO, TX 75033-4248
(972) 668-3376
(972) 668-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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