Provider Demographics
NPI:1245717586
Name:DUBOSE, JULIA (APRN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DUBOSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 RUSHMORE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-5252
Mailing Address - Country:US
Mailing Address - Phone:214-704-1634
Mailing Address - Fax:
Practice Address - Street 1:10840 TEXAS HEALTH TRL STE 240
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6850
Practice Address - Country:US
Practice Address - Phone:817-491-0223
Practice Address - Fax:817-491-0238
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138146207Q00000X, 363LF0000X
TXAP138136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner