Provider Demographics
NPI:1891468898
Name:EBONY MIDCALF NP & COMPANY
Entity Type:Organization
Organization Name:EBONY MIDCALF NP & COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MIDCALF
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:228-596-4612
Mailing Address - Street 1:7555 WARREN PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4145
Mailing Address - Country:US
Mailing Address - Phone:228-596-4612
Mailing Address - Fax:888-727-0593
Practice Address - Street 1:7555 WARREN PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4145
Practice Address - Country:US
Practice Address - Phone:228-596-4612
Practice Address - Fax:888-727-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty