Healthcare Provider Details

I. General information

NPI: 1821161050
Provider Name (Legal Business Name): ANGELA L HUFF MD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 BOLTON BOONE DR
DESOTO TX
75115
US

IV. Provider business mailing address

2719 BOLTON BOONE DR
DESOTO TX
75115
US

V. Phone/Fax

Practice location:
  • Phone: 972-572-7893
  • Fax: 972-572-7553
Mailing address:
  • Phone: 972-572-7893
  • Fax: 972-572-7553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberJ4225
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: