Provider Demographics
NPI:1063156420
Name:LIVINGSTON, ANGEL (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735863
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-5863
Mailing Address - Country:US
Mailing Address - Phone:281-888-8999
Mailing Address - Fax:281-305-4054
Practice Address - Street 1:1924 FOREST RIDGE DRIVE
Practice Address - Street 2:STE 300
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-8228
Practice Address - Country:US
Practice Address - Phone:281-888-8999
Practice Address - Fax:281-305-4054
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143620363LF0000X
AR219517363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner