Individual
AGNES TITILAYO DELEAWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
923 BENTWATER PKWY, CEDAR HILL, TX 75104-8268
(817) 521-3353
Mailing address
902 W PIONEER PKWY STE 101, GRAND PRAIRIE, TX 75051-4703
(817) 680-8148
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
736492
TX
Other
Enumeration date
11/22/2012
Last updated
01/10/2018
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