Healthcare Provider Details

I. General information

NPI: 1184620601
Provider Name (Legal Business Name): MIROSLAWA JOLANTA GIOVI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIROSLAWA JOLANTA LINDSEY, BODNAR, BORAWSKA PA-C

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 OAKLAND STREET TEXAS WOMAN'S UNIVERSITY
DENTON TX
76204-5467
US

IV. Provider business mailing address

1600 OAKHOLLOW DR
CORINTH TX
76210-1927
US

V. Phone/Fax

Practice location:
  • Phone: 940-898-3555
  • Fax: 940-898-3555
Mailing address:
  • Phone: 940-293-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA02800
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: