Individual
EYAYU GEBETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 HOUSTON ST, LAVON, TX 75166-1738
(469) 556-2495
Mailing address
214 HOUSTON ST, LAVON, TX 75166-1738
(469) 556-2495
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
989467
TX
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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