Healthcare Provider Details

I. General information

NPI: 1477935732
Provider Name (Legal Business Name): ARTHUR LEE BUMPAS III FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 W WHEATLAND RD
DALLAS TX
75237-3609
US

IV. Provider business mailing address

2420 W WHEATLAND RD
DALLAS TX
75237-3609
US

V. Phone/Fax

Practice location:
  • Phone: 214-930-7066
  • Fax:
Mailing address:
  • Phone: 214-930-7066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP127738
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: