Provider Demographics
NPI:1689288276
Name:EZEH, CHINYERE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHINYERE
Middle Name:
Last Name:EZEH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5294 BELT LINE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7571
Mailing Address - Country:US
Mailing Address - Phone:214-785-2200
Mailing Address - Fax:
Practice Address - Street 1:5294 BELT LINE RD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7571
Practice Address - Country:US
Practice Address - Phone:214-785-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily