Most Relevant Information
Provider Data
| NPI Number: | 1003644279 |
| Provider Name: | CARLA MARIES RICAFORT MARIANO AGACNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 1030792 |
Most Important Dates
| Enumeration Date: | 07/22/2024 |
| Last Updated: | 09/24/2024 |
Provider Practice Location
6201 HARRY HINES BLVD
DALLAS
TX
752355202
Practice Location Phone/Fax
| Phone: | 2146335555 |
| Fax: |
Provider Mailing Location
6908 LEFLORE DR
PLANO
TX
750748752
Provider Mailing Phone/Fax
| Phone: | 9177532395 |
| Fax: |