Provider Demographics
NPI:1427751023
Name:TEKIE, DAWIT
Entity type:Individual
Prefix:
First Name:DAWIT
Middle Name:
Last Name:TEKIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11991 AUDELIA RD APT 604
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4935
Mailing Address - Country:US
Mailing Address - Phone:510-379-0854
Mailing Address - Fax:
Practice Address - Street 1:11991 AUDELIA RD APT 604
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4935
Practice Address - Country:US
Practice Address - Phone:510-379-0854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)