Provider Demographics
NPI:1346122421
Name:ASIAMA, ELIZABETH O
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:O
Last Name:ASIAMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 744224
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-4224
Mailing Address - Country:US
Mailing Address - Phone:972-741-0606
Mailing Address - Fax:
Practice Address - Street 1:12484 ABRAMS RD APT 2202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3075
Practice Address - Country:US
Practice Address - Phone:972-741-0606
Practice Address - Fax:972-671-9396
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1192684363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty