ETSUB NEGUSSIE HAILESELASSIE (NPI# 1801312947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801312947 |
Entity Type | Individual |
Full Name | ETSUB NEGUSSIE HAILESELASSIE |
Practice Address |
1702 Arbor Creek Dr. Garland TX 75040 |
Mailing Address |
1702 Arbor Creek Dr Garland TX 75040-8912 |
Practice Telephone | 4692697259 |
Enumeration Date | 2017-08-21 |
Last Update Date | 2019-04-30 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085B0100X |
Radiology Specialization: Body Imaging |
454534 | TX | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
10641 Steppington Dr, Dallas, TX 752304676 | 4692697259 |
Street Address |
1702 ARBOR CREEK DR. |
City | GARLAND |
State | TX |
Zip Code | 75040 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467938407 | Craig R Baginski, Dds Inc | Dentist | 4433 Naaman Forest Blvd, Garland, TX 75040 | 2018-07-12 |
1356838981 | Firewheel Pediatric Dental Specialists Pllc | Dentist | 4880 N President George Bush Hwy Ste 104, Garland, TX 75040 | 2018-04-19 |
1073038089 | Ashakrishna Nair | Nurse Practitioner | 5702 Lavon Drive, Cvs, Garland, TX 75040 | 2017-08-10 |
1336672856 | Rosialyllc Dba Garland Adult Care Center | Clinic/Center | 3845 N. Garland Ave, 700b, Garland, TX 75040 | 2017-04-11 |
1699211276 | Yishak Yemane Abebu | Non-emergency Medical Transport (VAN) | 1502 Townbluff St., Garland, TX 75040 | 2017-01-06 |
1124478375 | Nisha Liz John P.l.l.c | Dentist | 3046 Lavon Drive, Suite 125,127, Garland, TX 75040 | 2016-06-20 |
1265893275 | A1 Hospice Care LLC | Hospice Care, Community Based | 317 Still Meadow Drive, Garland, TX 75040 | 2016-03-18 |
1922474345 | Wai Mei Lee | Dentist | 1309 Belt Line Rd, Unit A, Garland, TX 75040 | 2015-08-19 |
1972990901 | Turnpike Vision, PC | Optometrist | 485 Cedar Sage Space J13, Garland, TX 75040 | 2015-04-16 |
1063804896 | Susheela Kumari Chandmal | Registered Nurse | 2300, Marie Curie Blvd, Garland, TX 75040 | 2015-03-03 |
Find all providers in zip 75040 |
Taxonomy Code | 2085B0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Body Imaging |
A Radiology doctor of Osteopathy that specializes in Body Imaging. |
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508463415 | Ct Medical Group | Radiology | 11901 Shadow Creek Pkwy Ste 111b, Pearland, TX 77584-7346 | 2020-10-04 |
1225370273 | Gary Brent Mayes | Radiology | 5248 Lower Crabapple Rd, Fredericksburg, TX 78624-7594 | 2013-03-17 |
1578820866 | Kuang-wei Eric Chang | Radiology | 2112 Sw H K Dodgen Loop Ste 110, Temple, TX 76504-7011 | 2012-04-12 |
1043583008 | 1st South Texas Pain Management | Radiology | 1431 Wirt Rd., 113, Houston, TX 77055 | 2012-02-21 |
1194058800 | Carlos Maldonado, D.o., P.a. | Radiology | 2933 Lazy Lake Dr, Harlingen, TX 78550-8633 | 2009-09-13 |
1326235359 | Louisea Marie Raymun Bonoan Deomampo | Radiology | University of Texas Medical Branch- Radiology, 301 University Boulevard Route 0709, Galveston, TX 77555-0709 | 2007-10-03 |
1518180488 | Border Radiology Consultants PC | Radiology | 1155 N Zaragoza Rd, Suite C107, El Paso, TX 79907-1812 | 2007-04-10 |
1861551046 | Radiology Associates of North Texas Pa | Radiology | 2911 Oak Park Cir, Fort Worth, TX 76109-1893 | 2006-12-06 |
1851450969 | Radiology Associates of North Texas Pa | Radiology | 525 E Southlake Blvd, Southlake, TX 76092-6235 | 2006-12-06 |
1083798441 | Elizabeth Mooney | Radiology | 6599 Kings Crown E, San Antonio, TX 78233-4719 | 2006-10-24 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.