Provider Demographics
NPI:1053945550
Name:VENEZIANI, ULDA
Entity type:Individual
Prefix:
First Name:ULDA
Middle Name:
Last Name:VENEZIANI
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 1:3004 JEREMES LNDG
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-1544
Mailing Address - Country:US
Mailing Address - Phone:214-677-7583
Mailing Address - Fax:
Practice Address - Street 1:1900 OATES DR STE 138
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6802
Practice Address - Country:US
Practice Address - Phone:972-270-7600
Practice Address - Fax:972-270-9968
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145094363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology