Provider Demographics
NPI:1104206523
Name:ROSS, ANTONIA M (NP-C)
Entity Type:Individual
Prefix:
First Name:ANTONIA
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2735 VILLA CREEK DR
Mailing Address - Street 2:SUITE A291
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7454
Mailing Address - Country:US
Mailing Address - Phone:972-803-5434
Mailing Address - Fax:972-863-8977
Practice Address - Street 1:2735 VILLA CREEK DR
Practice Address - Street 2:SUITE A291
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7454
Practice Address - Country:US
Practice Address - Phone:972-803-5434
Practice Address - Fax:972-863-8977
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP128157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily