Hatshepsut Mboluji Newsome PA

NPI 1346587854 - Physician Assistant - 363A00000X

NPI Details
NPI 1346587854
Gender Female
Enumeration Date 01/04/2013
Last Updated 03/11/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
5301 WILLIAM D TATE AVE
GRAPEVINE TX, 76051, US
Phone (972) 906-8175
Fax
Business Location
350 N ERVAY ST
APT 2308
DALLAS TX, 75201-3830, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Texas
License Number PA08286
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According to our database, Hatshepsut Mboluji Newsome PA NPI is 1346587854, taxonomy code is 363A00000X and license number is PA08286, license state is located at Texas. Hatshepsut Mboluji Newsome PA physically located at 5301 William D Tate Ave, Grapevine TX, 76051. NPI Number Hatshepsut Mboluji Newsome PA has the Individual type.

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1346587854 NPI number is provided on an as is basis without warranty of any kind. 1346587854 is maintained by the National Plan & Provider Enumeration System. The contents of Hatshepsut Mboluji Newsome PA are for informational purposes only.