Provider Demographics
NPI:1003559428
Name:ARNAUTOV, SIMONA E (AGACNP)
Entity Type:Individual
Prefix:
First Name:SIMONA
Middle Name:E
Last Name:ARNAUTOV
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 E PRESIDENT GEORGE BUSH HWY STE 175
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3551
Mailing Address - Country:US
Mailing Address - Phone:214-635-5701
Mailing Address - Fax:844-289-7691
Practice Address - Street 1:3001 E PRESIDENT GEORGE BUSH HWY STE 175
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3551
Practice Address - Country:US
Practice Address - Phone:214-635-5701
Practice Address - Fax:844-289-7691
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073234363LA2100X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2C8885OtherMEDICARE- DALLAS COUNTY
TX2C8886OtherMEDICARE- COLLIN COUNTY