Individual
DANELLE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RTR, ARDMS
Contact information
Practice address
9441 LBJ FWY, SUITE 602, DALLAS, TX 75243-4545
(469) 249-1887
Mailing address
9441 LBJ FWY, SUITE 602, DALLAS, TX 75243-4545
(469) 249-1887
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
101592
MS
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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