MEDICARE: AGNES AONDO 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	363LF0000X	Family Nurse Practitioner	AP132302	TX

General Provider Information

NPI Number	:	1265982698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGNES AONDO NP

Provider Business Mailing Address
First Line	:	6609 MCCART AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-5633
Country	:	US
Telephone Number	:	817-386-7670
Fax Number	:	833-921-2174

Provider Business Practice Location Address
First Line	:	6609 MCCART AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-5633
Country	:	US
Telephone Number	:	817-386-7670
Fax Number	:	833-921-2174

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

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	06/05/2026

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