Most Relevant Information
Provider Data
| NPI Number: | 1003525841 |
| Provider Name: | DESARAE BOSS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | PA16222 |
Most Important Dates
| Enumeration Date: | 11/21/2022 |
| Last Updated: | 11/21/2022 |
Provider Practice Location
7515 GREENVILLE AVE STE 900
DALLAS
TX
752313851
Practice Location Phone/Fax
| Phone: | 8445853544 |
| Fax: |
Provider Mailing Location
350 VISTA COURT DR APT 4304
PLANO
TX
750740096
Provider Mailing Phone/Fax
| Phone: | 2830342899 |
| Fax: |