Provider Demographics
NPI:1811400047
Name:VARELA, CHRISTINE VERA (APRN FNP-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:VERA
Last Name:VARELA
Suffix:
Gender:F
Credentials: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 1:229 NE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76164-7205
Mailing Address - Country:US
Mailing Address - Phone:817-566-0478
Mailing Address - Fax:
Practice Address - Street 1:CLINICAS MI DOCTOR
Practice Address - Street 2:4200 S FREEWAY STE 106
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115
Practice Address - Country:US
Practice Address - Phone:817-566-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1811400047Medicaid