Individual
ELIZABETH MARIE FATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 PARK PLACE AVE, BEDFORD, TX 76022-6033
(817) 540-1157
Mailing address
1701 PARK PLACE AVE, BEDFORD, TX 76022-6033
(817) 540-1157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/29/2024
Last updated
04/24/2024
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