FANTA SUWANEH

GRAPEVINE, TX
NPI1497340228
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2021-03-03
Last Update Date2021-09-18
Business Address
FANTA SUWANEH PA
3801 WILLIAM D TATE AVE # 800A
GRAPEVINE, TX 76051-8755
Phone number: 817-488-8998
Mailing Address
FANTA SUWANEH PA
3801 WILLIAM D TATE AVE # 800A
GRAPEVINE, TX 76051-8755
Phone number: 817-488-8998
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