MAXI THEODORINE CHOUSAND

FORT WORTH, TX
NPI1366460941
Former NameMEIHATI SOEMIJARSIH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: TX  K8078)
Enumeration Date2006-07-18
Last Update Date2007-07-08
Business Address
-- MAXI THEODORINE CHOUSAND M.D.
300 W ROSEDALE ST
FORT WORTH, TX 76104-4856
Phone number: 817-882-6003
Mailing Address
-- MAXI THEODORINE CHOUSAND M.D.
2561 GREEN OAK DR
CARROLLTON, TX 75010-4224
Phone number: 972-307-9116
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