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General NPI Number Information
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NPI Number | 1932854981
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Entity Type | Organization
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Legal Business Name | ELEANOR HEALTH PROFESSIONAL TX, PLLC
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 8500 VILLAGE DR STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5510
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Country | US
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Telephone | 726-201-3047
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Fax | 833-629-0318
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | PORTSMOUTH
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State | NH
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Zip | 03802-0386
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Country | US
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Telephone | 919-366-8743
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | NZINGA AJABU HARRISON
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Credential | MD
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Telephone | 781-230-6838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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