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1275575755
DFW SUPER GROUP I LLC
PLANO, TX
NPI
1275575755
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Entity Type
Organization
Authorized Contact
LANA S. RALSTON
Manager
214-632-3514
Organization Subpart ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
Enumeration Date
2006-06-11
Last Update Date
2008-02-20
Business Address
DFW SUPER GROUP I LLC
3020 LEGACY DR STE. 100-399
PLANO, TX 75023-8322
Phone number: 214-632-3514
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Mailing Address
DFW SUPER GROUP I LLC
PO BOX 835850
RICHARDSON, TX 75083-5850
Phone number: 972-680-1577
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