Individual provider · NPI-1

Sovonia Lundy Mccoy

Clinic/Center · Rockwall, TX

NPI number1922871573
StatusActive
Last updated in NPPESNov 6, 2023

Details

NPI
1922871573
Entity type
Individual (NPI-1)
Name
Sovonia Lundy Mccoy
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 6, 2023
Certification date
Nov 6, 2023
Last updated
Nov 6, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

709 W Rusk St # B312
Rockwall, TX 75087-3056

Phone 214-317-2495

Mailing address

709 W Rusk St # B312
Rockwall, TX 75087-3056

Phone 214-317-2495

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