Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1994
NPI: 1558370221
Practice Locations (2)
1143 S BUCKNER BLVD, SUITE 100
Dallas, TX 752174304
1143 S BUCKNER BLVD, SUITE 100
DALLAS, TX 752174304
2143988950
Source: CMS National Downloadable File, September 2026.