Individual provider · NPI-1

Tiara Abdul-Khaaliq

Nurse Practitioner, Family · Dallas, TX

NPI number1023634664
StatusActive
Last updated in NPPESOct 7, 2024

Details

NPI
1023634664
Entity type
Individual (NPI-1)
Name
Tiara Abdul-Khaaliq
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 19, 2020
Certification date
Oct 7, 2024
Last updated
Oct 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family1023634664TXYes

Practice location

4785 Asher Pl
Dallas, TX 75204-6000

Phone 620-605-8201

Mailing address

3167 Sanctuary Dr
Cedar Hill, TX 75104-4501

Phone 620-605-8201

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