Individual
MIA ELENA PULIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 W PULASKI ST, FORT WORTH, TX 76104-2717
(682) 885-8012
Mailing address
2815 FAIRFIELD AVE, FORT WORTH, TX 76116-4622
(817) 673-8700
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
1-194521
AL
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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