Individual
PRISCILA VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
74 MCMAKIN RD STE 205, BARTONVILLE, TX 76226-8438
(940) 455-7200
(305) 682-1602
Mailing address
PO BOX 961205, FORTH WORTH, TX 76161-1205
(817) 740-8450
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1008694
TX
Other
Enumeration date
10/14/2005
Last updated
01/26/2021
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