Individual
ANTHONY ISITOR IYAMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6363 N STATE HIGHWAY 161 STE 100, IRVING, TX 75038-2239
(469) 200-3272
Mailing address
7264 BUCANERO, GRAND PRAIRIE, TX 75054-5533
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1099820
TX
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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