Individual
FNU TAKUGLADYSTABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9393 SKILLMAN ST APT 1822, DALLAS, TX 75243-7390
(469) 445-5986
Mailing address
9393 SKILLMAN ST APT 1822, DALLAS, TX 75243-7390
(469) 445-5986
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
346685
TX
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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