Provider Demographics
NPI:1740991132
Name:BOJANG, ALIEU (APRN (NP))
Entity type:Individual
Prefix:MR
First Name:ALIEU
Middle Name:
Last Name:BOJANG
Suffix:
Gender:M
Credentials:APRN (NP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75189-5023
Mailing Address - Country:US
Mailing Address - Phone:903-851-6765
Mailing Address - Fax:
Practice Address - Street 1:3351 WATERVIEW PKWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1449
Practice Address - Country:US
Practice Address - Phone:972-398-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily