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General NPI Number Information
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NPI Number | 1740655406
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Entity Type | Individual
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Provider Name | DEVONN DILLARD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 2620 GUS THOMASSON RD STE 102
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City | MESQUITE
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State | TX
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Zip | 75150-5417
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Country | US
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Telephone | 469-730-0044
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Fax | 469-730-0046
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Provider Business Mailing Address
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Address Line | 2620 GUS THOMASSON RD STE 102
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City | MESQUITE
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State | TX
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Zip | 75150-5417
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Country | US
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Telephone | 469-730-0044
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Fax | 469-730-0046
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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 | AP-144701
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 633233
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License Number State | TX
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