SOMSOUK SOUTHICHACK

EULESS, TX
NPI1497280598
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX  AP132679)
Enumeration Date2017-04-26
Last Update Date2018-11-15
Business Address
SOMSOUK SOUTHICHACK RN, PMHNP
3200 W EULESS BLVD
EULESS, TX 76040-6253
Phone number: 817-702-3100
Mailing Address
SOMSOUK SOUTHICHACK RN, PMHNP
PO BOX 732973
DALLAS, TX 75373-2973
Phone number: 817-702-8450
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