Individual
SELAM S TADESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(940) 783-5472
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT86009
TX
Other
Enumeration date
10/24/2021
Last updated
10/24/2021
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