MEDICARE: DANIEL ARHEWOH NURSE PRACTITIONER

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP141584	TX

General Provider Information

NPI Number	:	1285287763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ARHEWOH NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	110 W RANDOL MILL RD STE 200
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4612
Country	:	US
Telephone Number	:	682-392-5252
Fax Number	:	817-549-1161

Provider Business Practice Location Address
First Line	:	110 W RANDOL MILL RD STE 200
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4612
Country	:	US
Telephone Number	:	682-392-5252
Fax Number	:

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

Provider Enumeration Date	:	07/23/2019
Last Update Date	:	11/09/2023

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