MEDICARE: NADINE EFETI NDIP PHD, LP

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	103TC0700X	Clinical Psychologist	39533	TX

General Provider Information

NPI Number	:	1467175844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADINE EFETI NDIP PHD, LP

Provider Business Mailing Address
First Line	:	5575 WARREN PKWY STE 120
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-4093
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 GREENVILLE AVE STE 252
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-5037
Country	:	US
Telephone Number	:	214-618-8402
Fax Number	:

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

Provider Enumeration Date	:	09/21/2022
Last Update Date	:	01/20/2026

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