Healthcare Provider Details

I. General information

NPI: 1669614178
Provider Name (Legal Business Name): ESTHER A. FAIRCHILD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 10/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 WINDSOR FARMS DR
DENTON TX
76207-1294
US

IV. Provider business mailing address

2121 WINDSOR FARMS DR
DENTON TX
76207-1294
US

V. Phone/Fax

Practice location:
  • Phone: 940-453-2026
  • Fax: 888-329-6432
Mailing address:
  • Phone: 940-453-2026
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number637964
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number637964
License Number StateTX

VIII. Authorized Official

Name: ESTHER A FAIRCHILD
Title or Position: PRESIDENT
Credential: RNFA/WHNP
Phone: 940-453-2026