Provider Demographics
NPI:1558475335
Name:IFESINACHUKWU, FRANCISCA ADA (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCA
Middle Name:ADA
Last Name:IFESINACHUKWU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17906
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78760-7906
Mailing Address - Country:US
Mailing Address - Phone:512-732-2122
Mailing Address - Fax:512-732-2124
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE L 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8661
Practice Address - Country:US
Practice Address - Phone:512-732-2122
Practice Address - Fax:512-732-2124
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL16202084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173311501Medicaid
H59940Medicare UPIN
TX173311501Medicaid