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Individual

DR. RAYMOND NKWANTABISA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-7942
(682) 885-7956
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1860
(682) 885-1396

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
241495
NY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
N4624
TX

Other

Enumeration date
12/18/2006
Last updated
04/06/2021
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