Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1025178 | TX |
NPI | 1003338054 |
---|---|
Provider Name | Tabbie Mbaye |
First Address | Dallas, TX 75284-4658 |
Second Address | Taylor, TX 76574-1210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2017 |
Last Update Date | 09/08/2021 |