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General NPI Number Information
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NPI Number | 1518661982
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Entity Type | Individual
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Provider Name | KADIAH FORD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 3116 MARBLE FALLS DR
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City | FORNEY
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State | TX
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Zip | 75126-6699
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Country | US
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Telephone | 945-444-6650
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 EAST DAVIS ST SUITE 115 PMB 283
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City | MESQUITE
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State | TX
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Zip | 75149
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Country | US
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Telephone | 945-900-4331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 48320456
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License Number State | TX
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