NPI age
7 years
Enumerated 2018-10-29
● Active
Type 1 · Individual
Prajnawati Wibowo, NP
Wibowo is 1 of 335 nurse practitioner providers in Dallas and 1 of 5095 in Texas.
Primary specialty
Nurse Practitioner
Plus 2 subspecialties
Licensed in
TX, CA
2 states
Status
Active
No deactivations on record
Last NPPES update
2025-10-27
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 5095 active nurse practitioner providers in Texas.
NPI age
7 years
↑ 3 yr above median (4 yr)
State licenses
2 states
Top 89% — 10% of peers are multi-state
Subspecialties
1
In the 30% of peers with subspecialties
NPI lifetime · 2018 → 2026
2018-10Enumerated in NPPES
2018
2026
Where they practice
Practice location
5301 Alpha Rd Ste 80-3
Dallas, TX 752404355
Mailing address
5301 Alpha Rd Ste 80-3
Dallas, TX 752404355
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
-
Nurse PractitionerDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | AP139122 | LICENSE |
| 01 (CA) | 95034910 | LICENSE |
| 01 (TX) | XW5044653 | DATA 2000 WAIVER |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
Recently enumerated nearby: 14 new nurse practitioner providers have been added in Dallas in the last 180 days.
See all →
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.