LIVE WELL MD PA
Radiology at Buckner Blvd, Dallas, TX

License number
Texas G1042
Category
Radiology
Type
Vascular Surgery
Owner
Name: HENRY T HORRILLENO MD
Title: OWNER
Phone: (214) 388-4808
Address
Address
4808 S Buckner Blvd, Dallas, TX 75227
National Provider ID: 1265729453
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LIVE WELL, M.D., PA

12900 Preston Rd STE 804, Dallas, TX 75230

Doing business as:
Live Well, M.D., PA
Registration:
Jun 21, 2011
State ID:
0801442571
Business type:
Professional Association
Director, Member, President:
Henry Horrilleno (Director, Member, President)
TIN:
32044503368

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