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Individual

BENITA AMIRMAZAHERI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
874 ED HALL DR, SUITE 102-103, KAUFMAN, TX 75142-1861
(972) 932-9345
Mailing address
628 RAINTREE CIR, COPPELL, TX 75019-5447
(214) 295-7586

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
676122
TX

Other

Enumeration date
03/02/2010
Last updated
03/02/2010
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