PATRICK T. ROUGHNEEN, M.D,, P.A.
Medical Practice at College St, Grapevine, TX

License number
Texas J1480
Category
Medical Practice
Type
Specialist
Owner
Name: KIMCHI THI NGUYEN
Title: OFFICE MANAGER
Phone: (817) 552-1900
Address
Address
1600 W College St SUITE 555, Grapevine, TX 76051
National Provider ID: 1285848804
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PATRICK T. ROUGHNEEN, M.D., PA

1600 W College St STE 555, Grapevine, TX 76051

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Sep 23, 2004
State ID:
0800393933
Business type:
Professional Association
Member, Director, President, Treasurer, Vice-President, Secretary:
Patrick T. Roughneen Member, Director, President, Treasurer, Vice-President, Secretary, inactive
Agent:
Patrick Thomas Roughneen,1600 W College St SUITE 555, Grapevine, TX 76051 (Physical)
TIN:
32035533697

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