MEDICARE: AMY HADDAD 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	207Q00000X	Family Medicine Physician	875588	TX

General Provider Information

NPI Number	:	1326683467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HADDAD NP

Provider Business Mailing Address
First Line	:	4040 N COLLINS ST.
Second Line	:	STE 134
City	:	ARLINGTON
State	:	TX
Zip	:	76005
Country	:	US
Telephone Number	:	817-533-0988
Fax Number	:	817-533-1422

Provider Business Practice Location Address
First Line	:	4040 N COLLINS ST.
Second Line	:	STE 134
City	:	ARLINGTON
State	:	TX
Zip	:	76005
Country	:	US
Telephone Number	:	817-533-0988
Fax Number	:	817-533-1422

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

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	12/10/2025

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