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General NPI Number Information
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NPI Number | 1770184020
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Entity Type | Individual
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Provider Name | KARA FENCEROY
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 800 WEST RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76012
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Country | US
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Telephone | 713-417-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 800 W RANDOL MILL RD
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City | ARLINGTON
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State | TX
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Zip | 76012-2504
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Country | US
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Telephone | 817-960-6010
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F10201195
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F10201195
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License Number State | TX
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