Provider Demographics
NPI:1922392281
Name:FALCON, MONICA G (PA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:G
Last Name:FALCON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:222 LAS COLINAS BLVD W
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5421
Mailing Address - Country:US
Mailing Address - Phone:972-957-3000
Mailing Address - Fax:972-236-0096
Practice Address - Street 1:229 NE 28TH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76164-7205
Practice Address - Country:US
Practice Address - Phone:817-566-0483
Practice Address - Fax:817-566-0484
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA07800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB151994Medicare PIN
TXTXB151993Medicare PIN
TXTXB151995Medicare PIN