Provider Demographics
NPI:1265982698
Name:AONDO, AGNES (NP)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:AONDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 OAKBEND TRL STE 220
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3916
Mailing Address - Country:US
Mailing Address - Phone:817-346-4327
Mailing Address - Fax:817-346-4436
Practice Address - Street 1:5801 OAKBEND TRL STE 220
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3916
Practice Address - Country:US
Practice Address - Phone:817-346-4327
Practice Address - Fax:817-346-4436
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily