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General NPI Number Information
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NPI Number | 1588343578
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Entity Type | Individual
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Provider Name | JULIA ALLDREDGE
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Gender | Female
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 09/28/2023
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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 | 76104-4941
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Country | US
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Telephone | 817-702-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 8813 HERMAN ST
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City | WHITE SETTLEMENT
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State | TX
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Zip | 76108-1206
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Country | US
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Telephone | 817-944-0958
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 856736
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1135577
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License Number State | TX
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