Provider Demographics
NPI:1134549702
Name:ATITSO, FIONA GIRETTA (MD)
Entity type:Individual
Prefix:MS
First Name:FIONA
Middle Name:GIRETTA
Last Name:ATITSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CROWN POINTE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-1191
Mailing Address - Country:US
Mailing Address - Phone:817-599-7661
Mailing Address - Fax:817-599-8408
Practice Address - Street 1:101 CROWN POINTE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-1191
Practice Address - Country:US
Practice Address - Phone:817-599-7661
Practice Address - Fax:817-599-8408
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine