SMILE EMBASSY, PLLC.
Managed Care Organizations at Sunset Ave, Dallas, TX

License number
Texas 21771
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: DR. ELIUD VILLARREAL
Title: DOCTOR
Phone: (214) 943-2400
Address
Address
517 Sunset Ave, Dallas, TX 75208
National Provider ID: 1275998312
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SMILE EMBASSY, PLLC

517 Sunset Ave, Dallas, TX 75208

Doing business as:
Smile Embassy, Pllc
Registration:
Jul 1, 2014
State ID:
0802019921
Business type:
Domestic Limited Liability Company (LLC)
Manager:
Eliud Villarreal (Manager)
TIN:
32054506087

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