Provider Demographics
NPI:1215697115
Name:WABARA, JULIET I
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:I
Last Name:WABARA
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 1:9900 MOCCASIN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6525
Mailing Address - Country:US
Mailing Address - Phone:469-230-0504
Mailing Address - Fax:
Practice Address - Street 1:9900 MOCCASIN CREEK LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6525
Practice Address - Country:US
Practice Address - Phone:469-230-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143506363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health