MEDICARE: NDIFREKE ITATA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP135734	TX

General Provider Information

NPI Number	:	1174033286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NDIFREKE ITATA

Provider Business Mailing Address
First Line	:	2412 OLD NORTH RD STE 101K
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-1524
Country	:	US
Telephone Number	:	940-566-4999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2412 OLD NORTH RD STE 101K
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-1524
Country	:	US
Telephone Number	:	940-566-4999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2017
Last Update Date	:	02/01/2024

Similar Medicare Providers

1033279252 — PREMIER GOLDEN HEART HEALTH CARE SERVICES LLC
Practice Location Address:

2412 OLD NORTH RD STE 101K
DENTON, TX
76209-1524

Practice Phone: 940-566-4999
Practice Fax: 940-566-4992

1548474364 — DR. NATALIE ELIZABETH GOODMAN D.D.S
Practice Location Address:

2412 OLD NORTH RD STE 100A
DENTON, TX
76209-1524

Practice Phone: 940-382-9960
Practice Fax: 940-387-7014

1528347523 — DR. RACHEL MEDFORD DC
Practice Location Address:

2412 OLD NORTH RD , STE 100B
DENTON, TX
76209-1524

Practice Phone: 940-565-8118
Practice Fax: 940-387-3070

1346587854 — HATSHEPSUT MBOLUJI OSHUN PA
Practice Location Address:

2412 OLD NORTH RD STE 101
DENTON, TX
76209-1524

Practice Phone: 940-387-5800
Practice Fax:

1609358092 — ANDY H HASKIN OTA
Practice Location Address:

1524 CHURCHILL DR
DENTON, TX
76209-1376

Practice Phone: 940-566-2650
Practice Fax:

1740750801 — DENTON FAMILY CLINIC CORP
Practice Location Address:

2412 OLD NORTH RD STE 101
DENTON, TX
76209-1524

Practice Phone: 469-283-8708
Practice Fax:

Directions to “ NDIFREKE ITATA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.