Provider Demographics
NPI:1932753233
Name:DALMEIDA, NATACHA DEDE (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:NATACHA
Middle Name:DEDE
Last Name:DALMEIDA
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:DEDE
Other - Middle Name:DJIDO
Other - Last Name:DALMEIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1018 N CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75189-2301
Mailing Address - Country:US
Mailing Address - Phone:316-312-2737
Mailing Address - Fax:
Practice Address - Street 1:811 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4708
Practice Address - Country:US
Practice Address - Phone:316-312-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141207363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty