Individual
KONJIT A GEBREYOHANNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14058 ROLLING HILLS LN, DALLAS, TX 75240-3808
(214) 796-9729
Mailing address
333 MEADOWHILL DR, GARLAND, TX 75043-3023
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310206
TX
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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