Healthcare Provider Details

I. General information

NPI: 1568346609
Provider Name (Legal Business Name): XIAOFANG ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6351 S DESERT BLVD STE 106
EL PASO TX
79932-1219
US

IV. Provider business mailing address

6351 S DESERT BLVD STE 106
EL PASO TX
79932-1219
US

V. Phone/Fax

Practice location:
  • Phone: 915-499-0424
  • Fax: 915-260-8033
Mailing address:
  • Phone: 915-499-0424
  • Fax: 915-260-8033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT146663
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: