Provider Demographics
NPI:1952499543
Name:GRIFFIN, TERESA LEE (DNP APRN AGACNP FNP)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:LEE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:DNP APRN AGACNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9030
Mailing Address - Country:US
Mailing Address - Phone:214-645-7500
Mailing Address - Fax:
Practice Address - Street 1:6201 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-3154
Practice Address - Country:US
Practice Address - Phone:214-645-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649261363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX878N78OtherBCBS
TX191703101Medicaid
TX191703102Medicaid
TX8Y1348OtherBCBS OF TEXAS
TX752616977077OtherTRICARE
TX878N78OtherBCBS
TX191703101Medicaid
TX8J3689Medicare PIN
TX191703102Medicaid