Provider Demographics
NPI:1497965610
Name:CORSARO, NANCY L (LAC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:L
Last Name:CORSARO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 N CAPISTRANO DR
Mailing Address - Street 2:#186
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-4033
Mailing Address - Country:US
Mailing Address - Phone:214-793-5684
Mailing Address - Fax:
Practice Address - Street 1:14655 MIDWAY RD
Practice Address - Street 2:SUITE 122
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3146
Practice Address - Country:US
Practice Address - Phone:214-793-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00868171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist