Individual
AGNES AUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 INWOOD RD, 6TH FL, STE 6.102, DALLAS, TX 75390-9083
(214) 645-0595
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP138171
TX
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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