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General NPI Number Information
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NPI Number | 1184367880
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Entity Type | Organization
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Legal Business Name | KIDZ & FAMILY MEDICINE INC.
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 860 HEBRON PKWY STE 1202
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City | LEWISVILLE
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State | TX
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Zip | 75057-5146
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Country | US
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Telephone | 214-488-0071
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Fax |
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Provider Business Mailing Address
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Address Line | 860 HEBRON PKWY STE 1202
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City | LEWISVILLE
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State | TX
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Zip | 75057-5146
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Country | US
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Telephone | 214-488-0071
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | RAJI ANUP
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Credential | FNP
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Telephone | 214-405-4882
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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 | NULL
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