Provider Demographics
NPI:1134584089
Name:CROW, SHEENA KATRINA VALLIDO (NP)
Entity type:Individual
Prefix:
First Name:SHEENA KATRINA
Middle Name:VALLIDO
Last Name:CROW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHEENA KATRINA
Other - Middle Name:ARENAS
Other - Last Name:VALLIDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5320 VENTANA TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2326
Mailing Address - Country:US
Mailing Address - Phone:443-474-1537
Mailing Address - Fax:
Practice Address - Street 1:7515 GREENVILLE AVE STE 1010
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3858
Practice Address - Country:US
Practice Address - Phone:469-283-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-19
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX953977163W00000X
TXAP134798363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX388776201Medicaid