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Organization
EL SHADDAI FAMILY CLINIC LLC
Active
Organization
EL SHADDAI FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEENA PAUL NP-C (NURSE PRACTITIONER)
(469) 252-0101
Entity
Organization
Contact information
Practice address
1740 W VIRGINIA ST STE 400, MCKINNEY, TX 75069-7864
(469) 252-0101
Mailing address
1740 W VIRGINIA ST STE 400, MCKINNEY, TX 75069-7864
(469) 252-0101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
733997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568773893
INDIVIDUAL NPI
TX
Enumeration date
11/15/2013
Last updated
07/25/2019
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