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General NPI Number Information
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NPI Number | 1477799518
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Entity Type | Organization
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Legal Business Name | JPS HEALTH
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 12/19/2008
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Provider Practice Location Address
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Address Line | 1500 S MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4917
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Country | US
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Telephone | 817-927-3887
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 STONELEIGH CT APT 1012
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City | ARLINGTON
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State | TX
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Zip | 76011-2708
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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 | FAMILY NURSE PRACTITIONER
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Name | MISS ALBA ILIANA PEREZ
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Credential | FNP
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Telephone | 817-920-6353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 703992
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License Number State | TX
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