MEDICARE: IVANA PRISCILLA BUAMAH

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	1015129	TX

General Provider Information

NPI Number	:	1871189712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVANA PRISCILLA BUAMAH

Provider Business Mailing Address
First Line	:	3304 CREEKSIDE DR
Second Line	:
City	:	SACHSE
State	:	TX
Zip	:	75048-2366
Country	:	US
Telephone Number	:	972-821-2501
Fax Number	:

Provider Business Practice Location Address
First Line	:	429 E INTERSTATE 30 STE 114
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75043-4097
Country	:	US
Telephone Number	:	972-795-3292
Fax Number	:	972-767-0334

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

Provider Enumeration Date	:	12/15/2020
Last Update Date	:	01/16/2026

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Directions to “ IVANA PRISCILLA BUAMAH ” Practice Location

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