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General NPI Number Information
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NPI Number | 1982837811
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Entity Type | Individual
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Provider Name | LYZETE AKWI TALLA DNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 5515 E. EVANS ROAD SUITE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78261
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Country | US
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Telephone | 210-290-9740
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Fax | 210-291-9741
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Provider Business Mailing Address
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Address Line | 5515 E EVANS RD STE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78261-2025
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Country | US
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Telephone | 210-290-9740
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Fax | 210-291-9741
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 782593
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP137487
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License Number State | TX
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