Healthcare Provider Details

I. General information

NPI: 1821622259
Provider Name (Legal Business Name): DINAH M. OGETO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7117 SUGARPLUM DR
PLANO TX
75074-2058
US

IV. Provider business mailing address

7117 SUGARPLUM DR
PLANO TX
75074-2058
US

V. Phone/Fax

Practice location:
  • Phone: 972-339-2104
  • Fax:
Mailing address:
  • Phone: 972-339-2104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP144904
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: