MEDICARE: ENJIA XIONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1204442	TX

General Provider Information

NPI Number	:	1871470203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENJIA XIONG

Provider Business Mailing Address
First Line	:	5204 TX-360 SUITE 400 & 400A
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052
Country	:	US
Telephone Number	:	972-755-1785
Fax Number	:

Provider Business Practice Location Address
First Line	:	5204 S HWY 360 STE 400
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-0947
Country	:	US
Telephone Number	:	972-755-1785
Fax Number	:	972-755-1785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	02/03/2026

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Directions to “ ENJIA XIONG ” Practice Location

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