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Individual

DR. GANANA TESFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2800 E BROAD ST STE 517, MANSFIELD, TX 76063-6417
(817) 592-3002
(817) 549-5151
Mailing address
2800 E BROAD ST STE 517, MANSFIELD, TX 76063-6417
(817) 592-3360
(817) 549-5151

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TX
2084N0400X
Neurology Physician
H7663
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6R7554
GROUP MEDICARE PTAN
TX
01
8XC232
BCBS
TX
Enumeration date
01/10/2007
Last updated
06/27/2025
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