MEDICARE: DEMATRIA PLESHETTE HOLBROOK FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	725167	TX

General Provider Information

NPI Number	:	1053669010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEMATRIA PLESHETTE HOLBROOK FNP-C

Provider Business Mailing Address
First Line	:	5814 COLDSWORTH CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2386
Country	:	US
Telephone Number	:	817-915-6053
Fax Number	:

Provider Business Practice Location Address
First Line	:	5814 COLDSWORTH CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2386
Country	:	US
Telephone Number	:	817-915-6053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2012
Last Update Date	:	08/24/2012

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