Healthcare Provider Details

I. General information

NPI: 1811609530
Provider Name (Legal Business Name): BECOMING TOWANDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13052 DALLAS PKWY #210
FRISCO TX
75033-4241
US

IV. Provider business mailing address

1401 HARVEST RIDGE LANE
PROSPER TX
75078
US

V. Phone/Fax

Practice location:
  • Phone: 940-365-9001
  • Fax: 940-365-9009
Mailing address:
  • Phone: 713-628-9690
  • Fax: 940-365-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. HEATHER BARTOS
Title or Position: OWNER
Credential: MD
Phone: 713-628-9690