1003974999 NPI number — ADAORA NKECHI CRAWFORD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003974999 NPI number — ADAORA NKECHI CRAWFORD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRAWFORD
Provider First Name:
ADAORA
Provider Middle Name:
NKECHI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHUKWUMA
Provider Other First Name:
ADAORA
Provider Other Middle Name:
NKECHI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1003974999
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 167611
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75016-7611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-659-8980
Provider Business Mailing Address Fax Number:
972-659-8980

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4208 W NORTHGATE DR
Provider Second Line Business Practice Location Address:
#110
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75062-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-659-8980
Provider Business Practice Location Address Fax Number:
972-659-8980
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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