Lake Dallas Family Medicine Pllc
NPI #1871158907 in Lake Dallas, Texas
Provider Information
- NPI Number
- 1871158907
- Entity Type
- Organization
- Organization Name
- Lake Dallas Family Medicine Pllc
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- May 3, 2019
- Last Updated
- Jun 19, 2019
Practice Location
- Address
- 503 MAIN ST STE C
- City
- Lake Dallas
- State
- Texas
- ZIP Code
- 75065-2878
- Phone
- (940) 535-5296
Authorized Official
- Name
- MRS. CARMEN PHILLIPS WHITE, FNP-BC
- Title
- OWNER
- Phone
- (214) 908-6012
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Nurse Practitioner - Family — Family |
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