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General NPI Number Information
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NPI Number | 1154797801
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Entity Type | Organization
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Legal Business Name | FUSION FAMILY CONSULTING
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 1700 ALMA DR STE 480
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City | PLANO
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State | TX
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Zip | 75075-6937
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Country | US
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Telephone | 469-344-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 ALMA DR STE 480
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City | PLANO
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State | TX
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Zip | 75075-6937
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Country | US
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Telephone | 469-344-1414
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | AMEENA ISA
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Credential | MD
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Telephone | 469-450-1457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | P5083
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License Number State | TX
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