Healthcare Provider Details

I. General information

NPI: 1871096875
Provider Name (Legal Business Name): QIAN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 NEEDHAM DR
ALLEN TX
75013-3006
US

IV. Provider business mailing address

2033 NEEDHAM DR
ALLEN TX
75013-3006
US

V. Phone/Fax

Practice location:
  • Phone: 214-534-8492
  • Fax:
Mailing address:
  • Phone: 214-534-8492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number748184
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: