Agnes Titilayo Deleawe, NURSE PRACTITIONER

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

736492 Issued in TX

Practice address

923 Bentwater Pkwy
Cedar Hill, TX 75104-8268

Phone

(817) 521-3353

NPI assigned

Nov 22, 2012

Last updated

Jan 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adonai Family Healthcare

  • Primary Care Clinic/Center
  • Cedar Hill, TX
  • NPI 1497262992
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1871837328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W PIONEER PKWY STE 101",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514703",
            "telephone_number": "817-680-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 BENTWATER PKWY",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751048268",
            "telephone_number": "817-521-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEAWE",
        "first_name": "AGNES",
        "middle_name": "TITILAYO",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-22",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "736492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Davis, L.P.C.
• Day Medical Supply Company
• Philip Lynn Day
• Dayari's Gift Wellness PLLC
• Andrew Michael De la Vega, PA-C
• Diamond Derby
• Suvidha Dere, DDS
• Amlakbalew Getahun Derebe, PHARMD
• Dermatology Associates of Uptown, PA
• Tenisha Renee Derrick

• Licensed Practical Nurse in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Licensed Practical Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.