Provider Demographics
NPI:1760612097
Name:OJO, MOSES A (FNP)
Entity Type:Individual
Prefix:
First Name:MOSES
Middle Name:A
Last Name:OJO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 ST JOSEPH WAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4017
Mailing Address - Country:US
Mailing Address - Phone:214-893-2800
Mailing Address - Fax:817-468-8483
Practice Address - Street 1:2001 ST JOSEPH WAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-4017
Practice Address - Country:US
Practice Address - Phone:214-893-2800
Practice Address - Fax:817-468-8483
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX1084495363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No251E00000XAgenciesHome Health