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1871751404
DALE PARK
DALLAS, TX
NPI
1871751404
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2008-05-30
Last Update Date
2008-05-30
Business Address
-- DALE PARK CertPS
1545 W MOCKINGBIRD LN SUITE 3005
DALLAS, TX 75235-5014
Phone number: 214-819-9911
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Mailing Address
-- DALE PARK CertPS
1545 W MOCKINGBIRD LN SUITE 3005
DALLAS, TX 75235-5014
Phone number: 214-819-9911
Copy
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