Healthcare Provider Details

I. General information

NPI: 1245100502
Provider Name (Legal Business Name): ADY TAKWAI CHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7514 CORPORATE CENTER DR STE 100
MEMPHIS TN
38138-3877
US

IV. Provider business mailing address

7514 CORPORATE CENTER DR STE 100
GERMANTOWN TN
38138-3877
US

V. Phone/Fax

Practice location:
  • Phone: 901-757-5333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6997
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: