Provider Demographics
NPI:1891386579
Name:KAUSAR, TANZILA (MSN, AGACNP)
Entity Type:Individual
Prefix:
First Name:TANZILA
Middle Name:
Last Name:KAUSAR
Suffix:
Gender:F
Credentials:MSN, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 560811
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-0811
Mailing Address - Country:US
Mailing Address - Phone:972-679-9392
Mailing Address - Fax:
Practice Address - Street 1:2853 SHORELINE WAY
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-4161
Practice Address - Country:US
Practice Address - Phone:972-679-9392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020673363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health