Provider Demographics
NPI:1265513709
Name:BISHOP, JOANN (DO)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-3730
Mailing Address - Country:US
Mailing Address - Phone:817-909-9669
Mailing Address - Fax:
Practice Address - Street 1:391 ARBOR LN
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-3730
Practice Address - Country:US
Practice Address - Phone:817-909-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5971207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine