Provider Demographics
NPI:1194189696
Name:PAPILLION, NNEKA CRYSTAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NNEKA
Middle Name:CRYSTAL
Last Name:PAPILLION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NNEKA
Other - Middle Name:CRYSTAL
Other - Last Name:ONWUMERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2930 COUNTRY CIR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-2137
Mailing Address - Country:US
Mailing Address - Phone:214-621-7163
Mailing Address - Fax:
Practice Address - Street 1:614 EAKER ST
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:TX
Practice Address - Zip Code:76837-7683
Practice Address - Country:US
Practice Address - Phone:325-869-5911
Practice Address - Fax:325-869-5218
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS3271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program