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General NPI Number Information
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NPI Number | 1033761630
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Entity Type | Individual
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Provider Name | SIMON KAITEI
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Gender | Male
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Dates
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Enumeration Date | 07/12/2019
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 3312 TEASLEY LN # 100
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City | DENTON
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State | TX
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Zip | 76210-8315
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Country | US
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Telephone | 940-222-2399
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Fax |
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Provider Business Mailing Address
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Address Line | 3809 OCALA LN
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City | MCKINNEY
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State | TX
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Zip | 75070-0224
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Country | US
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Telephone | 214-945-6561
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP141844
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License Number State | TX
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