Individual
MS. ANTONIA REESE PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1450 8TH AVE, FORT WORTH, TX 76104-4110
(817) 923-4423
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP129402
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353183201
—
TX
01
—
P01800846
RAILROAD
TX
Enumeration date
11/03/2015
Last updated
04/12/2017
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