SearchTexas163W00000X

Dominique Idahor

NPI 1053780254 · on the registry since 2015 · sole proprietor

Practice

Address
5813 Lincoln Meadows Ct
409
Fort Worth, TX 76112
Phone
(817) 986-6999

Registry record

Primary taxonomy
163W00000X
163W00000X
Licence states on file
TX
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-09-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas