Healthcare Provider Details

I. General information

NPI: 1629933171
Provider Name (Legal Business Name): TELEMED WITH AMBREEN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 DEFOREST RD
COPPELL TX
75019-2740
US

IV. Provider business mailing address

917 DEFOREST RD
COPPELL TX
75019-2740
US

V. Phone/Fax

Practice location:
  • Phone: 469-569-0581
  • Fax:
Mailing address:
  • Phone: 469-569-0581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMBREEN ALWANI
Title or Position: OWNER
Credential: FNP-C
Phone: 469-569-0581