Provider Demographics
NPI:1457958738
Name:DAWADY, REETA R (NP)
Entity Type:Individual
Prefix:
First Name:REETA
Middle Name:R
Last Name:DAWADY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 ROUND ROCK AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4215
Mailing Address - Country:US
Mailing Address - Phone:512-388-9495
Mailing Address - Fax:512-716-0371
Practice Address - Street 1:1750 ROUND ROCK AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4215
Practice Address - Country:US
Practice Address - Phone:512-388-9495
Practice Address - Fax:512-716-0371
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1014622OtherAPRN