MEDICARE: FATOUMATA JALLOW

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	363L00000X	Nurse Practitioner	F01190769	TX

General Provider Information

NPI Number	:	1427519396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATOUMATA JALLOW

Provider Business Mailing Address
First Line	:	2304 CROMWELL DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2560
Country	:	US
Telephone Number	:	817-862-6156
Fax Number	:

Provider Business Practice Location Address
First Line	:	2304 CROMWELL DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2560
Country	:	US
Telephone Number	:	817-862-6156
Fax Number	:

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

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	12/03/2025

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