Provider Demographics
NPI:1598126880
Name:VERITAS NP GROUP,LLC
Entity Type:Organization
Organization Name:VERITAS NP GROUP,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA ROLANDA
Authorized Official - Middle Name:GAMBOA
Authorized Official - Last Name:BOLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN NP-C, FNP-BC
Authorized Official - Phone:972-366-5533
Mailing Address - Street 1:11625 CUSTER ROAD
Mailing Address - Street 2:SUITE 110, #315
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8784
Mailing Address - Country:US
Mailing Address - Phone:972-366-5533
Mailing Address - Fax:888-859-0497
Practice Address - Street 1:2525 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-2634
Practice Address - Country:US
Practice Address - Phone:972-366-5533
Practice Address - Fax:888-859-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121789363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3618860Medicaid