Advanced NPS of North Texas LLC

Organization Active NPI Nurse Practitioner · Farmers Branch, TX

NPI 1043944952 · NPPES record last updated Jan 22, 2024

Key facts

NPI
1043944952
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
ADVANCED NPS OF NORTH TEXAS LLC
Practice address
7 Medical Pkwy
Farmers Branch, TX 75234-7829
Phone
(903) 563-4146
NPI assigned
Jul 15, 2022
Organization subpart
No

Authorized official

Name
Kaitlin Blalock, NP
Title
Provider
Phone
(903) 563-4146

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220810001329 TX Part B Supplier - Clinic/Group Practice 5395128219 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX; Farmers Branch, TX; Lancaster, TX; Sherman, TX

National Provider Directory

Locations

14902 Preston Rd
Ste 404-813
Dallas, TX 75254

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X Yes

Addresses

Primary practice location

7 Medical Pkwy
Farmers Branch, TX 75234-7829

Mailing address

14902 Preston Rd Ste 404-813
Dallas, TX 75254-9105
Phone (903) 563-4146

Other providers in Farmers Branch, TX

All providers in Farmers Branch, TX · Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.