Individual
MS. TABITHA VIOLA BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
7777 FOREST LN STE C840, DALLAS, TX 75230-2594
(972) 566-3340
Mailing address
7545 E NORTHWEST HWY APT 103, DALLAS, TX 75238-4202
(214) 493-0826
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP126991
TX
363LP0200X
Pediatric Nurse Practitioner
AP126991
TX
Other
Enumeration date
02/02/2015
Last updated
03/23/2026
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