Provider Demographics
NPI:1891161394
Name:PINEDA, ANGELA (NP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:PINEDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13000 BELLA ITALIA CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-6106
Mailing Address - Country:US
Mailing Address - Phone:817-615-8627
Mailing Address - Fax:817-615-8574
Practice Address - Street 1:11797 SOUTH FWY STE 246
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7035
Practice Address - Country:US
Practice Address - Phone:817-615-8627
Practice Address - Fax:817-615-8574
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003161363L00000X, 363LG0600X
TXAP128647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology