Individual
CHIYON CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W MAGNOLIA AVE, FORT WORTH, TX 76104-7617
(817) 288-9700
Mailing address
6000 HARRY HINES BLVD SUITE ND2.300, DALLAS, TX 75390-8574
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1034109
TX
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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