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General NPI Number Information
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NPI Number | 1205500048
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Entity Type | Individual
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Provider Name | EMY CHARLOT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 325 N SAINT PAUL ST STE 3100
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City | DALLAS
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State | TX
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Zip | 75201-3923
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Country | US
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Telephone | 469-516-3357
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Fax |
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Provider Business Mailing Address
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Address Line | 2532 ALDEN AVE
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City | DALLAS
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State | TX
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Zip | 75211-2713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1018794
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License Number State | TX
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