Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1993
NPI: 1871621326
Practice Locations (1)
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
5200 HARRY HINES BLVD
DALLAS, TX 752357709
2145908000
Source: CMS National Downloadable File, September 2026.