Fajardo, Anthony L

Fajardo, Anthony L is an individual health care provider with primary practice located at 6363 N State Highway 161 Ste 100 , Irving TX 75038-2239. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is his primary health care specialty. Fajardo, Anthony L can be contacted via phone (469) 200-3272.

Contact Information

Primary practice address
6363 N State Highway 161 Ste 100 Irving TX 75038-2239
Phone: (469) 200-3272
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP135476 Texas
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP135476 Texas

Profile Details

NPI number 1407367592
LBN Legal business name Fajardo, Anthony L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2017
Last updated Feb 21st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407367592 NPPES
Texas Other 1174155477 NPI

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