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NPI Code Detail

MEDICARE: ANGELICA ESTRADA NP

MEDICARE: ANGELICA ESTRADA NP
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
1363LF0000XFamily Nurse PractitionerAP130629TX

General Provider Information

NPI Number : 1205298528
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELICA ESTRADA NP
Provider Business Mailing Address
First Line : PO BOX 732973
Second Line :
City : DALLAS
State : TX
Zip : 75373-7002
Country : US
Telephone Number : 817-702-2450
Fax Number : 817-237-0611
Provider Business Practice Location Address
First Line : 3308 DEEN RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76106-6524
Country : US
Telephone Number : 817-702-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2016
Last Update Date : 08/29/2022

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