MEDICARE: STEPHANIE RAE SVOBODA PAWELEK FNP

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	AP134304	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP134304	OTHER	TX	FNP

General Provider Information

NPI Number	:	1174049134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE RAE SVOBODA PAWELEK FNP

Provider Business Mailing Address
First Line	:	4900 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7719
Country	:	US
Telephone Number	:	214-590-5524
Fax Number	:	214-590-6950

Provider Business Practice Location Address
First Line	:	4900 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7719
Country	:	US
Telephone Number	:	214-590-5524
Fax Number	:	214-590-6950

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

Provider Enumeration Date	:	08/21/2017
Last Update Date	:	01/12/2025

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