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General NPI Number Information
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NPI Number | 1295450641
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Entity Type | Individual
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Provider Name | MISTY AVILA FNP
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Gender | Female
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Dates
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Enumeration Date | 10/07/2022
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Last Update Date | 03/08/2026
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Provider Practice Location Address
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Address Line | 16750 WESTGROVE DR
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City | ADDISON
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State | TX
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Zip | 75001-5688
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Country | US
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Telephone | 214-954-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 2141 BRYN MAWR DR
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City | PROSPER
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State | TX
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Zip | 75078-2434
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Country | US
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Telephone | 512-791-4779
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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 | 1096240
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License Number State | TX
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