Individual
AUDREY MARIETTA PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1441 N BECKLEY AVE, DALLAS, TX 75203-1201
(214) 947-6700
Mailing address
5623 HAMILTON WOLFE APT 523, SAN ANTONIO, TX 78240-4055
(847) 840-8790
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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