Tiara Abdul-Khaaliq

Individual provider Active NPI Family Nurse Practitioner · Dallas, TX

NPI 1023634664 · NPPES record last updated Oct 7, 2024

Key facts

NPI
1023634664
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
1023634664 (TX)
Practice address
4785 Asher PL
Dallas, TX 75204-6000
Phone
(620) 605-8201
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1023634664TXMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1023634664 TX Yes

Addresses

Primary practice location

4785 Asher PL
Dallas, TX 75204-6000

Mailing address

3167 Sanctuary Dr
Cedar Hill, TX 75104-4501
Phone (620) 605-8201

Other providers in Dallas, TX

All providers in Dallas, TX · Family Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.