Individual
SIJI SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
411 N WASHINGTON AVE STE 6000, DALLAS, TX 75246-1789
(214) 358-2300
(214) 579-6988
Mailing address
1505 LBJ FWY STE 700, DALLAS, TX 75234-6065
(214) 358-2300
(214) 579-6941
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1029999
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029999
LICENSE
TX
Enumeration date
09/24/2021
Last updated
05/07/2024
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