ELLEN J. DUTTA, MD, PA
Osteopathic Medicine at Dallas Pkwy, Addison, TX

License number
Texas L2872
Category
Osteopathic Medicine
Type
Allergy & Immunology
Owner
Name: ELLEN JOY DUTTA MD
Title: OWNER
Phone: (972) 250-4016
Address
Address
16901 Dallas Pkwy SUITE 206, Addison, TX 75001
National Provider ID: 1093988685
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ELLEN J. DUTTA, M.D., PA

16901 Dallas Pkwy STE 206, Addison, TX 75001

Status:
Inactive
Registration:
May 3, 2002
State ID:
0800080931
Agent:
Paritosh C Dutta,16901 N Dallas Pkwy, Addison, TX 75001 (Physical)
TIN:
17530491202

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