Provider Demographics
NPI:1841684396
Name:CHOI, AELIM (ARNP)
Entity type:Individual
Prefix:
First Name:AELIM
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:ARNP
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:1729 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1349
Practice Address - Country:US
Practice Address - Phone:682-885-3301
Practice Address - Fax:682-885-3399
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127725363LF0000X, 364SA2200X, 364SH1100X, 364SL0600X, 364SG0600X
WAAP61327530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364SH1100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHolistic
No364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61327530OtherMEDICAL LICENSE
TX353876101Medicaid
TX8056NUOtherBCBS
WA2242233Medicaid