Individual
ALEGNTAYE YIRDAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2709 S BUCKNER BLVD, DALLAS, TX 75227-6904
(214) 388-1100
Mailing address
7700 CODY LN APT 3044, SACHSE, TX 75048-6687
(214) 205-1319
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP142463
TX
363LG0600X
Gerontology Nurse Practitioner
AP142463
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP142463
TX
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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