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Erin Medina

NPI Registration Record

Provider / OrganizationNPIDate Certified
ERIN MEDINA11347381562020-07-26
Entity TypeIndividual
Provider Name Erin Medina
Practice Office Address7510 E GRAND AVE APT 1304
DALLAS, TX US
Practice Office Telephone9037990553
Mailing Address7510 E GRAND AVE APT 1304
DALLAS, TX 752144163 US
Business Telephone9037990553
HPT Codes
CodeLicense NoState
122300000X PRIMARY36404 TX
193400000X SINGGroup Code
OPI Codes

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