Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP108445 | TX |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 516017 | TX |
NPI | 1154364420 |
---|---|
Provider Name | Ms. Phyllis L Bargas |
First Address | Fort Worth, TX 76104-4917 |
Second Address | Fort Worth, TX 76104-4917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 28/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
044386303 | (05) | TX |