Ralf Wancha, NP
Nurse Practitioner in Plano, TX. Individual provider (NPI-1).
NPI number1164068391
StatusActive
Last updated in NPPESOct 19, 2020
Details
- NPI
- 1164068391
- Entity type
- Individual (NPI-1)
- Name
- Ralf Wancha
- Credential
- NP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 22, 2019
- Certification date
- Oct 19, 2020
- Last updated
- Oct 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 2019058471 | TX | Yes |
Practice location
1947 K Ave Ste A400Plano, TX 75074-5943
Phone 972-535-5099
Mailing address
1411 N Beckley Ave Ste 152Dallas, TX 75203-1586
Phone 214-948-7700 · Fax 214-948-7701
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