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General NPI Number Information
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NPI Number | 1760297162
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Entity Type | Individual
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Provider Name | SOUAD HAWKINS-EZZAHER
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2800 E BROAD ST STE 400
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City | MANSFIELD
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State | TX
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Zip | 76063-6414
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Country | US
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Telephone | 817-675-0828
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Fax |
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Provider Business Mailing Address
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Address Line | 7227 BRISA RD
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-0089
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Country | US
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Telephone | 817-675-0828
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1025624
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License Number State | TX
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