Provider Demographics
NPI:1467716704
Name:JULINE, PATRICIA L (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:JULINE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:L
Other - Last Name:JULINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11551 FOREST CENTRAL DR STE 133
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3915
Mailing Address - Country:US
Mailing Address - Phone:214-343-8565
Mailing Address - Fax:214-342-3054
Practice Address - Street 1:1600 W COLLEGE ST STE 440
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3584
Practice Address - Country:US
Practice Address - Phone:817-865-6200
Practice Address - Fax:817-865-6065
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2292363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIOTH000Medicare UPIN