Individual
ENOS ODEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3773 TIMBERGLEN RD APT 805, DALLAS, TX 75287-3719
(214) 862-2951
Mailing address
3773 TIMBERGLEN RD APT 805, DALLAS, TX 75287-3719
(214) 862-2951
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
777392
TX
163WG0000X
General Practice Registered Nurse
Primary
777392
TX
374U00000X
Home Health Aide
777392
TX
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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