MEDICARE: DENISIA MAWAH

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	1125860	TX

General Provider Information

NPI Number	:	1700732906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISIA MAWAH

Provider Business Mailing Address
First Line	:	2701 THORNHILL LN
Second Line	:
City	:	VENUS
State	:	TX
Zip	:	76084-3694
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 S LANCASTER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	214-742-8387
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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Directions to “ DENISIA MAWAH ” Practice Location

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