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General NPI Number Information
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NPI Number | 1851995682
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Entity Type | Individual
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Provider Name | CHRISTINA BAZAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 5077 E INTERSTATE 20 SERVICE RD N
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City | WILLOW PARK
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State | TX
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Zip | 76087-3219
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Country | US
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Telephone | 817-374-4949
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Fax | 866-493-3919
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Provider Business Mailing Address
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Address Line | 5077 E INTERSTATE 20 SERVICE RD N
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City | WILLOW PARK
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State | TX
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Zip | 76087-3219
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Country | US
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Telephone | 817-374-4949
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Fax | 866-493-3919
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1018921
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License Number State | TX
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