Healthcare Provider Details

I. General information

NPI: 1396419800
Provider Name (Legal Business Name): ABINA LUITEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 LOUISIANA RD
DYESS AFB TX
79607-1141
US

IV. Provider business mailing address

697 LOUISIANA RD
DYESS AFB TX
79607-1141
US

V. Phone/Fax

Practice location:
  • Phone: 325-696-6600
  • Fax:
Mailing address:
  • Phone: 325-696-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10003790
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1052248
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: