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1851397046
IDA MADOKA LIGHTFOOT
PLANO, TX
NPI
1851397046
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Former Name
IDA M ARMSTRONG
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX 593409)
Enumeration Date
2005-06-22
Last Update Date
2021-07-19
Business Address
IDA MADOKA LIGHTFOOT RN, PMHNP
6404 INTERNATIONAL PKWY STE 1010
PLANO, TX 75093-8346
Phone number: 972-267-1988
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Mailing Address
IDA MADOKA LIGHTFOOT RN, PMHNP
1241 FOREST PARK DR
WEATHERFORD, TX 76087-2805
Phone number: 817-821-9978
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