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General NPI Number Information
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NPI Number | 1083101075
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Entity Type | Organization
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Legal Business Name | HEPHZIBAH VISITING CLINICIANS
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 1534 N HAMPTON RD STE 100
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City | DESOTO
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State | TX
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Zip | 75115-2493
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Country | US
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Telephone | 469-941-4029
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Fax | 866-803-8759
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Provider Business Mailing Address
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Address Line | 1534 N HAMPTON RD STE 100
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City | DESOTO
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State | TX
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Zip | 75115-2493
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Country | US
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Telephone | 469-585-8129
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Fax | 866-803-8759
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SIMINIBE MONEKE
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Credential |
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Telephone | 469-585-8129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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