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1144406612

NPI Code Detail

MEDICARE: VALORIE TADLOCK APRN

MEDICARE: VALORIE TADLOCK APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	602214	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP113767	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144406612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALORIE TADLOCK APRN

Provider Business Mailing Address
First Line	:	PO BOX 732973
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-4403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 W TERRELL AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3243
Country	:	US
Telephone Number	:	817-702-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2008
Last Update Date	:	05/19/2023

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Directions to “ VALORIE TADLOCK APRN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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