Provider Demographics
NPI:1629801014
Name:WAFAYEE, AARON (NP)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:WAFAYEE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 W MOCKINGBIRD LN STE 315
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-6312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:817-242-3174
Practice Address - Street 1:1250 W MOCKINGBIRD LN STE 315
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4902
Practice Address - Country:US
Practice Address - Phone:214-247-6568
Practice Address - Fax:817-242-3174
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170216363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health