Healthcare Provider Details

I. General information

NPI: 1497416549
Provider Name (Legal Business Name): NZINGA DARNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 EMPIRE CENTRAL DR STE 205
DALLAS TX
75247-4018
US

IV. Provider business mailing address

PO BOX 171463
DALLAS TX
75217-1158
US

V. Phone/Fax

Practice location:
  • Phone: 254-248-8387
  • Fax:
Mailing address:
  • Phone: 254-248-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: