1225695133 NPI number — MRS. LYNDA JIFON AGBASI DNP, PMHNP, FNP

Table of content: BRIDGETT ANN'LOUISE HITES (NPI 1629298203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225695133 NPI number — MRS. LYNDA JIFON AGBASI DNP, PMHNP, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGBASI
Provider First Name:
LYNDA
Provider Middle Name:
JIFON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DNP, PMHNP, FNP
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:
1225695133
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5473 BLAIR RD PMB 145244
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-4227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-233-6069
Provider Business Mailing Address Fax Number:
210-352-9661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5473 BLAIR RD PMB 145244
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-4227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-233-6069
Provider Business Practice Location Address Fax Number:
210-352-9661
Provider Enumeration Date:
05/26/2019

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:  AP141658 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: AP141658 , 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)





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