Organization
INTERNAL MEDICINE AND PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE WISTL (OFFICE MANAGER)
(214) 239-1053
Entity
Organization
Contact information
Practice address
2821 GEORGE BUSH HWY, 501, RICHARDSON, TX 75082-4266
(214) 239-1053
(214) 239-1058
Mailing address
2821 GEORGE BUSH HWY, 501, RICHARDSON, TX 75082-4266
(214) 239-1053
(214) 239-1058
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
TSBME-K7949
TX
Other
Enumeration date
10/10/2007
Last updated
10/10/2007
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