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Individual

ALEXANDER M TANJUAKIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
3100 MCKINNON ST, SUITE 400, DALLAS, TX 75201-1044
(214) 754-8700
(214) 239-3769
Mailing address
10605 LANSDOWNE LN, ROWLETT, TX 75089-8388
(214) 577-5016
(972) 463-6523

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
701513
TX

Other

Enumeration date
07/10/2010
Last updated
01/18/2012
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