Provider Demographics
NPI:1609356880
Name:RICE, CHIBUZOR JANAE
Entity Type:Individual
Prefix:
First Name:CHIBUZOR
Middle Name:JANAE
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 W PLEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1111
Mailing Address - Country:US
Mailing Address - Phone:972-228-8029
Mailing Address - Fax:
Practice Address - Street 1:2535 W PLEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1111
Practice Address - Country:US
Practice Address - Phone:972-228-8029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2065300225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant