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General NPI Number Information
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NPI Number | 1679710404
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Entity Type | Individual
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Provider Name | SIRAJUNNISA SYEDA P.A.
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Gender | Female
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 1300 W TERRELL AVE STE K230
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City | FORT WORTH
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State | TX
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Zip | 76104-3104
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Country | US
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Telephone | 817-250-4906
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Fax |
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Provider Business Mailing Address
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Address Line | 6130 W PARKER RD STE 306
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City | PLANO
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State | TX
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Zip | 75093-7934
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Country | US
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Telephone | 972-981-7135
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Fax | 972-981-7136
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA09320
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License Number State | TX
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