Individual
DENISE ANN PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13140 COIT RD STE 315, DALLAS, TX 75240-5753
(214) 272-7829
(972) 777-9896
Mailing address
12801 PARKERSBURG DR, FORT WORTH, TX 76244-5719
(720) 273-1961
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1105740
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
NA
—
Enumeration date
01/12/2023
Last updated
02/10/2025
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