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1154596765
FREDRIC CLARK PUCKETT
ENNIS, TX
NPI
1154596765
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TX N1080)
Enumeration Date
2008-04-24
Last Update Date
2022-04-05
Business Address
Dr. FREDRIC CLARK PUCKETT D.O.
2203 W LAMPASAS ST SUITE 205
ENNIS, TX 75119-5644
Phone number: 972-875-6200
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Mailing Address
Dr. FREDRIC CLARK PUCKETT D.O.
2203 W LAMPASAS ST STE 111
ENNIS, TX 75119-5667
Phone number: 972-875-6200
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