MEDICARE: LINDA G ROPER 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	363L00000X	Nurse Practitioner	226114	TX

General Provider Information

NPI Number	:	1346290723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA G ROPER NP

Provider Business Mailing Address
First Line	:	PO BOX 195
Second Line	:
City	:	BULLARD
State	:	TX
Zip	:	75757-0195
Country	:	US
Telephone Number	:	903-894-7206
Fax Number	:	903-894-6119

Provider Business Practice Location Address
First Line	:	105 PHILLIPS ST.
Second Line	:
City	:	BULLARD
State	:	TX
Zip	:	75757
Country	:	US
Telephone Number	:	903-894-7206
Fax Number	:	903-894-6119

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/08/2007

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