GRACE SYOMBUA JEDIDAH NPI 1386375665

NPI Information

  • NPI: 1386375665
  • Provider Name: GRACE SYOMBUA JEDIDAH
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 539 W COMMERCE ST # 3213
    DALLAS, TX
    ZIP 75208
  • Phone: (682) 593-0477

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NPI Details

Grace Syombua Jedidah is a psychiatric/mental health nurse practitioner in Dallas, TX with 4 years of experience. Grace Syombua Jedidah NPI is 1386375665. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

539 W COMMERCE ST # 3213
DALLAS, TX
ZIP 75208-953
Phone: (682) 593-0477
Fax: (682) 593-0477

The NPI 1386375665 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/18/2022 and was last updated on 1/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health1059626TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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