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General NPI Number Information
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NPI Number | 1598577959
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Entity Type | Individual
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Provider Name | ANU XANDY ALEXANDER MATHEW CPNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3900 W 15TH ST STE 107
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City | PLANO
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State | TX
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Zip | 75075-7789
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Country | US
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Telephone | 972-964-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 2812 GOOSEBERRY DR
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City | PLANO
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State | TX
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Zip | 75074-2044
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Country | US
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Telephone | 469-554-3532
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 779589
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP143843
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License Number State | TX
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