MEDICARE: DALYA ELSWEISY-GREEN AGACNP

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	390200000X	Student in an Organized Health Care Education/Training Program		TX

General Provider Information

NPI Number	:	1477409621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALYA ELSWEISY-GREEN AGACNP

Provider Business Mailing Address
First Line	:	506 CAMPBELL DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-3153
Country	:	US
Telephone Number	:	832-829-3780
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 CAMPBELL DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-3153
Country	:	US
Telephone Number	:	832-829-3780
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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