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General NPI Number Information
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NPI Number | 1215543632
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Entity Type | Organization
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Legal Business Name | MARIE DIBRA MD PLLC
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 3800 GAYLORD PKWY # 1190
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City | FRISCO
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State | TX
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Zip | 75034-9416
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Country | US
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Telephone | 844-409-4657
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Fax | 214-614-4277
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Provider Business Mailing Address
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Address Line | 3800 GAYLORD PKWY # 1190
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City | FRISCO
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State | TX
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Zip | 75034-9416
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Country | US
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Telephone | 844-409-4657
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Fax | 214-614-4277
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Authorized Official
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Title or Position | OWNER
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Name | MARIE DIBRA
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Credential | MD
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Telephone | 844-409-4657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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