=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184620601
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MIROSLAWA JOLANTA GIOVI PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2005
-----------------------------------------------------
Last Update Date | 08/04/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1219 OAKLAND STREET TEXAS WOMAN'S UNIVERSITY
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76204-5467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-898-3555
-----------------------------------------------------
Fax | 940-898-3555
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1600 OAKHOLLOW DR
-----------------------------------------------------
City | CORINTH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76210-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-293-3171
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA02800
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------