Basic Information
| Provider Information | |||||||||
| NPI: | 1629402896 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ACHERE | ||||||||
| FirstName: | RANDIBELLA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2959 S BUCKNER BLVD STE 700 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752276950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142064974 | ||||||||
| FaxNumber: | 2142064979 | ||||||||
| Practice Location | |||||||||
| Address1: | 2959 S BUCKNER BLVD | ||||||||
| Address2: | SUITE 700 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752276945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142064974 | ||||||||
| FaxNumber: | 2142064979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2013 | ||||||||
| LastUpdateDate: | 10/08/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 760452 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | AP123717 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.