Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | Q5218 | TX |
NPI | 1790002640 |
---|---|
Provider Name | Dr. Colleen Forsyth Macmurdo |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2010 |
Last Update Date | 27/01/2022 |