Provider Demographics
NPI:1629679147
Name:AWAD, MAGDOLEEN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MAGDOLEEN
Middle Name:
Last Name:AWAD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:AWAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1602 MORNING DOVE CT
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1602 MORNING DOVE CT
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1462
Practice Address - Country:US
Practice Address - Phone:214-836-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016416363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care