Healthcare Provider Details

I. General information

NPI: 1033869540
Provider Name (Legal Business Name): CHINAZA ESKAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 03/27/2022
Certification Date: 03/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 FERRIS AVE
WAXAHACHIE TX
75165-1862
US

IV. Provider business mailing address

1314 FERRIS AVE
WAXAHACHIE TX
75165-1862
US

V. Phone/Fax

Practice location:
  • Phone: 469-242-0960
  • Fax: 806-203-5082
Mailing address:
  • Phone: 469-242-0960
  • Fax: 806-203-5082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: