Provider Information for 1356772289
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MARQUITA Y. CLAY
Sex: Female
NPI: 1356772289
Last Updated: 2017-03-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1356772289 | ||||||||||||
| Enumeration Date | 2013-12-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 17330 PRESTON RD STE. 200D DALLAS, TX 75252-5997 United States Phone: 469-285-2530 | Fax:214-602-6900 | ||||||||||||
| Primary Practice Address | 17330 PRESTON RD STE. 200D DALLAS, TX 75252-5997 United States Phone: 469-285-2530 | Fax:214-602-6900 | ||||||||||||
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