MEDICARE: AQUIA WARD NP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	706757	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

General Provider Information

NPI Number	:	1154516441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AQUIA WARD NP

Provider Business Mailing Address
First Line	:	2301 S HAMPTON RD
Second Line	:	STE 200
City	:	DALLAS
State	:	TX
Zip	:	75224-1650
Country	:	US
Telephone Number	:	214-339-5336
Fax Number	:	214-339-5362

Provider Business Practice Location Address
First Line	:	2301 S HAMPTON RD
Second Line	:	STE 200
City	:	DALLAS
State	:	TX
Zip	:	75224-1650
Country	:	US
Telephone Number	:	214-339-5336
Fax Number	:	214-339-5362

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

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	08/04/2016

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