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General NPI Number Information
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NPI Number | 1831556174
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Entity Type | Individual
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Provider Name | MONIQUE LAVERNE WOODS NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/18/2016
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Last Update Date | 01/21/2024
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Provider Practice Location Address
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Address Line | 1311 W PRESIDENT GEORGE BUSH HWY
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City | RICHARDSON
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State | TX
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Zip | 75080-1153
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Country | US
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Telephone | 469-251-4401
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Fax |
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Provider Business Mailing Address
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Address Line | 1311 W PRESIDENT GEORGE BUSH HWY
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City | RICHARDSON
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State | TX
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Zip | 75080-1153
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Country | US
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Telephone | 469-814-3892
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP126261
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License Number State | OH
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