Healthcare Provider Details

I. General information

NPI: 1083983464
Provider Name (Legal Business Name): ENJOY YOUR LIFE FAMILY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2011
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S BROADWAY ST STE 260
CARROLLTON TX
75006-7277
US

IV. Provider business mailing address

1101 S BROADWAY ST STE 260
CARROLLTON TX
75006-7277
US

V. Phone/Fax

Practice location:
  • Phone: 972-625-2631
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number201026
License Number StateTX

VIII. Authorized Official

Name: DR. TERESA MASDON
Title or Position: FOUNDER/DIRECTOR
Credential: PHD
Phone: 972-625-2631