Healthcare Provider Details

I. General information

NPI: 1780847327
Provider Name (Legal Business Name): JULIANA OWUSU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MARIE CURIE DR
GARLAND TX
75042-5706
US

IV. Provider business mailing address

1717 MAIN ST STE 5200
DALLAS TX
75201-7365
US

V. Phone/Fax

Practice location:
  • Phone: 972-487-5332
  • Fax: 214-712-2444
Mailing address:
  • Phone: 214-712-5200
  • Fax: 214-712-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number658017
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: