Individual
MRS. DARLA JEAN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7312 BUFORD DR, DALLAS, TX 75241-4505
(469) 616-9164
Mailing address
7312 BUFORD DR, DALLAS, TX 75241-4505
(469) 616-9164
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
305341
TX
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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