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:PO BOX 270428
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-0428
Mailing Address - Country:US
Mailing Address - Phone:817-681-8805
Mailing Address - Fax:855-631-0835
Practice Address - Street 1:2260 POOL RD
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-4278
Practice Address - Country:US
Practice Address - Phone:817-481-6342
Practice Address - Fax:817-416-7475
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2025-05-29
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
TXAP129085OtherSTATE LICENS
TX2J9148OtherMEDICARE NUMBER