Individual
ERIKA WAITES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5400 CONROY ST, FORT WORTH, TX 76134-1608
(817) 706-9210
Mailing address
5400 CONROY ST, FORT WORTH, TX 76134-1608
(817) 706-9210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
917349
TX
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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