Organization
EMERALD LAINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERI ELKINS (PRESIDENT)
(817) 637-5438
Entity
Organization
Contact information
Practice address
3836 ARUNDEL AVE, FORT WORTH, TX 76109-3542
(817) 637-5438
Mailing address
3836 ARUNDEL AVE, FORT WORTH, TX 76109-3542
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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