Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1800X | Optician | ||
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 630732 | TX |
NPI | 1235463449 |
---|---|
Provider Name | Galina Ronin |
First Address | Colleyville, TX 76034-6080 |
Second Address | Dallas, TX 75235-7709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2009 |
Last Update Date | 02/10/2020 |