Healthcare Provider Details

I. General information

NPI: 1710607452
Provider Name (Legal Business Name): CHERE ANOKWU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4749 SAMUELL BLVD APT 200
MESQUITE TX
75149-1084
US

IV. Provider business mailing address

4749 SAMUELL BLVD APT 200
MESQUITE TX
75149-1084
US

V. Phone/Fax

Practice location:
  • Phone: 903-830-7701
  • Fax:
Mailing address:
  • Phone: 903-830-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: