Patricia L Archilles, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Bedford, TX
NPI 1598052201 · NPPES record last updated Apr 2, 2012
Key facts
- NPI
- 1598052201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 248897 (TX)
- Practice address
- 2716 Tibbets Dr
Bedford, TX 76022-6915 - Phone
- (817) 571-6644
- Fax
- (817) 685-7951
- NPI assigned
- Jul 1, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Pediatric Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 248897 | TX | Yes |
Addresses
Primary practice location
2716 Tibbets Dr
Bedford, TX 76022-6915
Mailing address
PO Box 99371
Fort Worth, TX 76199-0371
Phone (682) 885-1855
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 285838302 | Other | TX | CSHCN |
| 285838303 | Medicaid | TX |
Other providers in Bedford, TX
- Dawn Michelle Anzualda
- Apela CHI Medical, Inc.
- Apex Diagnostic Imaging LLP
- April Parker HCS LLC
- Araphaho Interventional Pain Center, LLC
- Erick Arellano
- Arete Medical Group
- Ahmar Arif
- Henry A Arnold
- Ascend Sports & Orthopaedic Physical Therapy LLC
All providers in Bedford, TX · Pediatric Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.