SOUTH LOOP 12 MEDICAL CLINIC LLC

DALLAS, TX
NPI1417034745
Entity TypeOrganization
Authorized ContactCONNIE FRANCES NELLUM
Family Nurse Pactitione Certified
214-398-4157
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: TX  528675)
Enumeration Date2006-11-01
Last Update Date2014-10-09
Business Address
SOUTH LOOP 12 MEDICAL CLINIC LLC
3232 GREAT TRINITY FOREST WAY STE. 102
DALLAS, TX 75216-7732
Phone number: 214-398-4157
Mailing Address
SOUTH LOOP 12 MEDICAL CLINIC LLC
3232 GREAT TRINITY FOREST WAY STE. 102
DALLAS, TX 75216-7732
Phone number: 214-398-4157