Most Relevant Information
Provider Data
| NPI Number: | 1003819426 |
| Provider Name: | W CRYSUP SORY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0202X |
| Specialty: | Radiology |
| License Number: | F4552 |
Most Important Dates
| Enumeration Date: | 05/31/2005 |
| Last Updated: | 02/05/2021 |
Provider Practice Location
12700 PARK CENTRAL DR
STE 430
DALLAS
TX
752511527
Practice Location Phone/Fax
| Phone: | 9722398902 |
| Fax: | 9726612551 |
Provider Mailing Location
PO BOX 740608
DALLAS
TX
753740608
Provider Mailing Phone/Fax
| Phone: | 4693179900 |
| Fax: |