MEDICARE: KRISTEN BOLTON P.A.

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	363A00000X	Physician Assistant	PA03880	TX

General Provider Information

NPI Number	:	1275641342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN BOLTON P.A.

Provider Business Mailing Address
First Line	:	3800 N TARRANT PKWY STE 210
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-5416
Country	:	US
Telephone Number	:	682-593-6660
Fax Number	:	888-289-2380

Provider Business Practice Location Address
First Line	:	3800 N TARRANT PKWY STE 210
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-5416
Country	:	US
Telephone Number	:	682-593-6660
Fax Number	:

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

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	06/18/2025

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Directions to “ KRISTEN BOLTON P.A.” Practice Location

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