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Specialty details in registry · Rockwall, TX

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At a glance

1063 E Interstate 30, Rockwall, TX 75087-4826

NPPES record updated Apr 3, 2014. Public records can lag behind changes at a practice.

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Practice location

1063 E Interstate 30
Rockwall, TX 75087-4826

Professional details: NPI, taxonomy & registry record

NPI1033537329

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 156FX1800X
Enumeration date: Apr 3, 2014
Record updated: Apr 3, 2014

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

156FX1800X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1063 E Interstate 30
Rockwall, TX 75087-4826

Phone: (469) 434-3021
Fax: (469) 434-3026

Mailing address

296 GRAYSON HWY

LAWRENCEVILLE, GA 300465737

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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