Healthcare Provider Details

I. General information

NPI: 1790275329
Provider Name (Legal Business Name): CHINENYE ANN AMAJOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 MCKINNEY AVE STE 700
DALLAS TX
75202-1241
US

IV. Provider business mailing address

PO BOX 8887
GREENVILLE TX
75404-8887
US

V. Phone/Fax

Practice location:
  • Phone: 972-505-1584
  • Fax: 844-582-3627
Mailing address:
  • Phone: 903-200-1277
  • Fax: 903-269-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP136311
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: