MEDICARE: TELEMED WITH AMBREEN PLLC

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

General Provider Information

NPI Number	:	1629933171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELEMED WITH AMBREEN PLLC

Provider Business Mailing Address
First Line	:	917 DEFOREST RD
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-2740
Country	:	US
Telephone Number	:	469-569-0581
Fax Number	:

Provider Business Practice Location Address
First Line	:	917 DEFOREST RD
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-2740
Country	:	US
Telephone Number	:	469-569-0581
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMBREEN ALWANI
Credential	:	FNP-C
Telephone Number	:	469-569-0581

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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