Provider Demographics
NPI:1356664049
Name:EBERENDU, LINDA OLUCHI (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:OLUCHI
Last Name:EBERENDU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 APACHE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-1166
Mailing Address - Country:US
Mailing Address - Phone:972-897-9905
Mailing Address - Fax:
Practice Address - Street 1:9555 LEBANON RD
Practice Address - Street 2:STE 801
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6095
Practice Address - Country:US
Practice Address - Phone:972-712-0200
Practice Address - Fax:972-712-2303
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor