Individual
PHEBA DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
901 N GALLOWAY AVE, STE 107, MESQUITE, TX 75149-2493
(972) 216-5152
Mailing address
425 BANDERA LN, SUNNYVALE, TX 75182-4611
(214) 695-9165
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP126974
TX
363LG0600X
Gerontology Nurse Practitioner
AP126974
TX
Other
Enumeration date
12/25/2014
Last updated
12/25/2014
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