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General NPI Number Information
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NPI Number | 1750836441
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Entity Type | Individual
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Provider Name | MONICA GORDON AGNP-C.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 3501 N MACARTHUR BLVD STE 330
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City | IRVING
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State | TX
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Zip | 75062
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Country | US
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Telephone | 972-607-2340
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Fax | 972-607-2347
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Provider Business Mailing Address
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Address Line | 3501 N MACARTHUR BLVD STE 330
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City | IRVING
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State | TX
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Zip | 75062-3611
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Country | US
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Telephone | 972-607-2340
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Fax | 972-607-2347
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP131536
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License Number State | TX
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