Provider Demographics
NPI:1942068572
Name:DANIEL, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 CHALKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-2907
Mailing Address - Country:US
Mailing Address - Phone:214-724-2328
Mailing Address - Fax:
Practice Address - Street 1:620 N COIT RD STE 2175
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-6202
Practice Address - Country:US
Practice Address - Phone:972-231-3134
Practice Address - Fax:972-231-3234
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140901363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics