1316112196 NPI number — DR. DOROTHY KILLAH BUDZI FNP, DPH, MSN, MBA

Table of content: KATHRYN M WISSER DO (NPI 1073545273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316112196 NPI number — DR. DOROTHY KILLAH BUDZI FNP, DPH, MSN, MBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUDZI
Provider First Name:
DOROTHY
Provider Middle Name:
KILLAH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
FNP, DPH, MSN, MBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316112196
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1618 SKYLINE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75043-1771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-886-9106
Provider Business Mailing Address Fax Number:
214-703-3971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1618 SKYLINE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75043-1771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-886-9106
Provider Business Practice Location Address Fax Number:
214-703-3971
Provider Enumeration Date:
04/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1007344 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com