Provider Demographics
NPI:1700255684
Name:MASLOW, TABETHA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TABETHA
Middle Name:
Last Name:MASLOW
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 W SPRING CREEK PKWY STE 400-C
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5237
Mailing Address - Country:US
Mailing Address - Phone:469-983-5000
Mailing Address - Fax:469-983-5555
Practice Address - Street 1:4116 W SPRING CREEK PKWY STE 400-C
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5237
Practice Address - Country:US
Practice Address - Phone:469-983-5000
Practice Address - Fax:469-983-5555
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2J9148OtherMEDICARE NUMBER
TXAP129085OtherSTATE LICENS