Individual
MS. PHYLLIS L BARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 921-3431
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 921-3431
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
AP108445
TX
363LP0200X
Pediatric Nurse Practitioner
516017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044386303
—
TX
Enumeration date
06/14/2006
Last updated
06/28/2016
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