Individual
YAMAMAH MOHAMMAD ISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
8224 PARK LN STE 130, VICKERY HEALTH CENTER, DALLAS, TX 75231-6021
(214) 266-0350
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
654555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196040301
—
TX
05
—
196040302
—
TX
05
—
196040303
—
TX
05
—
196040305
—
TX
05
—
196040306
—
TX
05
—
196040307
—
TX
05
—
196040308
—
TX
05
—
196040309
—
TX
05
—
196040310
—
TX
01
—
8Y2336
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/05/2007
Last updated
06/01/2009
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