Provider Demographics
NPI:1487154159
Name:DANIEL, TATIANA CAROLINA (APRN)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:CAROLINA
Last Name:DANIEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2627 W JEFFERSON BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-2685
Mailing Address - Country:US
Mailing Address - Phone:214-941-0032
Mailing Address - Fax:214-580-3514
Practice Address - Street 1:2627 W JEFFERSON BLVD STE 209
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-2685
Practice Address - Country:US
Practice Address - Phone:214-941-0032
Practice Address - Fax:214-580-3514
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136418363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily