Provider Demographics
NPI:1548721368
Name:GEORGE, ANCY ABRAHAM (FNP)
Entity type:Individual
Prefix:
First Name:ANCY
Middle Name:ABRAHAM
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4912
Mailing Address - Country:US
Mailing Address - Phone:972-686-7400
Mailing Address - Fax:972-686-7496
Practice Address - Street 1:4702 NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4912
Practice Address - Country:US
Practice Address - Phone:972-686-7400
Practice Address - Fax:972-686-7496
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily