Healthcare Provider Details

I. General information

NPI: 1720943863
Provider Name (Legal Business Name): JULIANA FROES DENNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 U OF A WAY
TEXARKANA AR
71854-1419
US

IV. Provider business mailing address

4001 NW 122ND ST APT 733
OKLAHOMA CITY OK
73120-9223
US

V. Phone/Fax

Practice location:
  • Phone: 870-779-6000
  • Fax:
Mailing address:
  • Phone: 469-487-2708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: