Doctor Name: | MARY JOYCE PALECEK |
NPI Number: | 1801806526 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFNP |
License Number: | R48132 |
Business Practice Address: | 3203 S Main St Lindale, TX - 757717727 |
Business Phone Number: | 9038820991 |
Business Fax Number: | |
Mailing Address: | Po Box 846098, DALLAS |
State: | TX |
Postal Code: | 752846098 |
Phone Number: | 9033246450 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 11/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R48132 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |