Provider Demographics
NPI:1376280578
Name:DANIELA DILLMAN NP PLLC
Entity Type:Organization
Organization Name:DANIELA DILLMAN NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:817-354-7999
Mailing Address - Street 1:4214 GATEWAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7906
Mailing Address - Country:US
Mailing Address - Phone:817-354-7999
Mailing Address - Fax:817-571-2140
Practice Address - Street 1:4214 GATEWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7906
Practice Address - Country:US
Practice Address - Phone:817-354-7999
Practice Address - Fax:817-571-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty