MEDICARE: AGNES CHOO NP-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	95017828	CA
2	363LF0000X	Family Nurse Practitioner	1082348	TX

General Provider Information

NPI Number	:	1477953388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGNES CHOO NP-C

Provider Business Mailing Address
First Line	:	P.O. BOX 735863
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-5863
Country	:	US
Telephone Number	:	281-888-8999
Fax Number	:	281-305-4054

Provider Business Practice Location Address
First Line	:	1924 FOREST RIDGE DRIVE
Second Line	:	STE 300
City	:	BEDFORD
State	:	TX
Zip	:	76021-8228
Country	:	US
Telephone Number	:	281-888-8999
Fax Number	:	281-305-4054

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

Provider Enumeration Date	:	08/27/2014
Last Update Date	:	02/16/2023

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