Provider Demographics
NPI:1225695133
Name:AGBASI, LYNDA JIFON (DNP, PMHNP, FNP)
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:JIFON
Last Name:AGBASI
Suffix:
Gender:F
Credentials:DNP, PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 BLAIR RD PMB 145244
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4227
Mailing Address - Country:US
Mailing Address - Phone:214-233-6069
Mailing Address - Fax:210-352-9661
Practice Address - Street 1:5473 BLAIR RD PMB 145244
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4227
Practice Address - Country:US
Practice Address - Phone:214-233-6069
Practice Address - Fax:210-352-9661
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-26
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141658363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily