Provider Demographics
NPI:1316301831
Name:BACANI-CRUZ, JULIENNE (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:JULIENNE
Middle Name:
Last Name:BACANI-CRUZ
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18601 LBJ FWY STE 310
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5612
Mailing Address - Country:US
Mailing Address - Phone:214-782-9222
Mailing Address - Fax:214-782-9333
Practice Address - Street 1:18601 LBJ FWY
Practice Address - Street 2:SUITE 310
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5600
Practice Address - Country:US
Practice Address - Phone:214-782-9222
Practice Address - Fax:214-782-9333
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner