Individual
MIRIAM NDENECHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
(254) 724-7603
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R225189
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
1052250
TX
367500000X
Certified Registered Nurse Anesthetist
D185741
IA
Other
Enumeration date
11/10/2020
Last updated
04/28/2026
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