Individual
JUDY PRATHOUMVANH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1441 N BECKLEY AVE, DALLAS, TX 75203-1201
(214) 960-5681
Mailing address
221 W COLORADO BLVD, PAV 2/SUITE 525, DALLAS, TX 75208
(817) 851-5358
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1019614
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1019614
TX
Other
Enumeration date
11/30/2020
Last updated
03/25/2025
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