KSJGQ LLC NPI 1225689144

NPI Information

NPI: 1225689144
Provider Name: KSJGQ LLC

Doing Business As: KSJGQ

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
9009 WHITE ROCK TRL
DALLAS, TX
ZIP 75238
Phone: (214) 636-0418
Get Directions

KSJGQ LLC is a family nurse practitioner in Dallas, TX. KSJGQ LLC NPI is 1225689144. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ksjgq.

The provider's business location address is:

9009 WHITE ROCK TRL
DALLAS, TX
ZIP 75238-347
Phone: (214) 636-0418

The provider's authorized official is Lawrence Idigbe .
The authorized official title is Nurse Practitioner and has the following contact phone number (214) 636-0418.

The enumeration date for this NPI number is 9/23/2019 and was last updated on 7/29/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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