Organization · NPI-2

Dfw Family Clinic

Physician Assistant, Medical · Grand Prairie, TX

NPI number1962881441
StatusActive
Last updated in NPPESMay 29, 2015

Details

NPI
1962881441
Entity type
Organization (NPI-2)
Legal business name
Dfw Family Clinic
Organization subpart
No
Enumeration date
May 29, 2015
Last updated
May 29, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, MedicalPA09381TXYes

Practice location

2771 Sherman St
Grand Prairie, TX 75051-6016

Phone 972-647-0550

Mailing address

2771 Sherman St
Grand Prairie, TX 75051-6016

Phone 972-647-0550

Authorized official

Adila N. Siddiqi
Physician
9726470550

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