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General NPI Number Information
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NPI Number | 1376838771
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Entity Type | Individual
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Provider Name | EYERUSALEM ENGIDA BAYSSA M.D
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Gender | Female
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 3800 GAYLORD PKWY STE 910
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City | FRISCO
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State | TX
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Zip | 75034-9419
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Country | US
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Telephone | 214-358-2300
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Fax | 972-685-4881
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Provider Business Mailing Address
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Address Line | 1505 LBJ FWY STE 700
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City | DALLAS
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State | TX
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Zip | 75234-6065
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Country | US
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Telephone | 214-358-2300
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Fax | 214-579-6941
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | R2053
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License Number State | TX
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