Provider Demographics
NPI:1871851725
Name:SIRIBA, DENNIS (RN, BSN)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SIRIBA
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 S PASS RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2157
Mailing Address - Country:US
Mailing Address - Phone:214-771-5349
Mailing Address - Fax:
Practice Address - Street 1:14101 S PASS RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-2157
Practice Address - Country:US
Practice Address - Phone:214-771-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX796578163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse