NPI 1164669974

Shatorya Ann Modkins

Organisation Preferred Provider Organization Dallas, TX

Practice location

Address: 4342 Lashley Dr, Dallas, TX 75232-1186
Phone: (214) 208-6402

Authorised official

Name: Shatorya Ann Modkins
Title: Ceo
Phone: (214) 208-6402

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

Other Preferred Provider Organization providers in Texas →

Registry record

NPI: 1164669974
Entity type: Organization
NPI issued: 15 Jan 2009
Record last updated: 15 Jan 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.