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1942319173
KRISTINA WIDJAJA
DALLAS, TX
NPI
1942319173
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA03752)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
Ms. KRISTINA WIDJAJA PA-C
4500 S LANCASTER RD
DALLAS, TX 75216-7167
Phone number: 214-857-2171
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Mailing Address
Ms. KRISTINA WIDJAJA PA-C
4500 S LANCASTER RD
DALLAS, TX 75216-7167
Phone number: 214-857-2171
Copy
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