Individual
GEORGY EKENNIA EBEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6140 MODELLI DR, GRAND PRAIRIE, TX 75052-8726
(214) 516-9847
Mailing address
6140 MODELLI DR, GRAND PRAIRIE, TX 75052-8726
(214) 516-9847
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
220226
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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