Misty Booker
Technician, Other in Desoto, TX. Individual provider (NPI-1).
NPI number1063860203
StatusActive
Last updated in NPPESMay 27, 2016
Details
- NPI
- 1063860203
- Entity type
- Individual (NPI-1)
- Name
- Misty Booker
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 27, 2016
- Last updated
- May 27, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
1204 Rosemont DrDesoto, TX 75115-1505
Phone 469-831-2064
Mailing address
1204 Rosemont DrDesoto, TX 75115-1505
Phone 469-831-2064
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