Provider Demographics
NPI:1851995682
Name:BAZAN, CHRISTINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BAZAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 MATLOCK RD STE 405
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2924
Mailing Address - Country:US
Mailing Address - Phone:817-472-6555
Mailing Address - Fax:817-472-6562
Practice Address - Street 1:3150 MATLOCK RD STE 405
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2924
Practice Address - Country:US
Practice Address - Phone:817-472-6555
Practice Address - Fax:817-472-6562
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily