Provider Demographics
NPI:1982603833
Name:AUNKO, ISRAEL JEROME (FNP)
Entity Type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:JEROME
Last Name:AUNKO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MINUTE CLINIC # 4985
Mailing Address - Street 2:8335 WESTCHESTER DR., STE. 140
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-0784
Mailing Address - Country:US
Mailing Address - Phone:214-706-6916
Mailing Address - Fax:401-652-9787
Practice Address - Street 1:8335 WESTCHESTER DR STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5717
Practice Address - Country:US
Practice Address - Phone:214-706-6916
Practice Address - Fax:214-369-3784
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109980363LF0000X
TX664465363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163844701Medicaid
TX163844702Medicaid
TX8K6295Medicare PIN
TX163844702Medicaid
TX8B4747Medicare ID - Type Unspecified00968R