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1467921411
BRANDON LOUIS SOUKUP
DALLAS, TX
NPI
1467921411
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX 686187)
Enumeration Date
2018-11-20
Last Update Date
2018-11-20
Business Address
BRANDON LOUIS SOUKUP
7450 HOLLY HILL DR APT 104
DALLAS, TX 75231-5321
Phone number: 254-722-9724
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Mailing Address
BRANDON LOUIS SOUKUP
7450 HOLLY HILL DR APT 104
DALLAS, TX 75231-5321
Phone number: 254-722-9724
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