KELSOM CLINIC PA
Marriage and Family Therapists at Pioneer Dr, Irving, TX

License number
Texas K2252
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: CATHERINE OKORONKWO MD
Title: MD
Phone: (972) 254-7272
Address
Address
1202 W Pioneer Dr SUITE 100, Irving, TX 75061
National Provider ID: 1104840594
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KELSOM CLINIC, PA

Irving, TX

Status:
Inactive
Doing business as:
Kelsom Clinic, PA
Registration:
Jun 30, 2005
Addresses:
1202 W Pioneer Dr STE 100, Irving, TX 75061 (Mailing)
1711 W Irving Blvd, Irving, TX 75061
State ID:
0800513560
Business type:
Professional Association
President , Director , Member , Secretary:
Katherine Okoronkwo President , Director , Member , Secretary, inactive
Agent:
Catherine Okoronkwo,1202 W Pioneer Dr STE 100, Irving, TX 75061 (Physical)
TIN:
32002174491

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