Medical school: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1174713754
Practice Locations (2)
REVIVE MED PARTNERS, LLC
2570 FM, 407 SUITE 160
HIGHLAND VILLAGE, TX 750773055
9722367060
IMED PHYSICIAN NETWORK, INC.
2700 W PLEASANT RUN RD, SUITE 340
LANCASTER, TX 751461074
4692840782
Source: CMS National Downloadable File, September 2026.