Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | Q9093 | TX |
NPI | 1134446073 |
---|---|
Provider Name | Kristal L Woldu |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2010 |
Last Update Date | 12/04/2021 |