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1871986109
CLINIC 21 OF TARRANT COUNTY, PLLC
SOUTHLAKE, TX
NPI
1871986109
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Entity Type
Organization
Authorized Contact
DAVID C PACKO
President
330-493-4443
Organization Subpart ?
No
Primary Taxonomy
207P00000X Emergency Medicine
Enumeration Date
2015-03-11
Last Update Date
2015-11-16
Business Address
CLINIC 21 OF TARRANT COUNTY, PLLC
431 E. STATE HIGHWAY 114 SUITE 120
SOUTHLAKE, TX 76092-4407
Phone number: 817-251-3981
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Mailing Address
CLINIC 21 OF TARRANT COUNTY, PLLC
4535 DRESSLER RD NW
CANTON, OH 44718-2545
Phone number: 330-493-4443
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