Provider Demographics
NPI:1972590867
Name:EST PROFESSIONAL HEALTHCARE,INC
Entity Type:Organization
Organization Name:EST PROFESSIONAL HEALTHCARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:N
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:972-270-8300
Mailing Address - Street 1:3129 US HIGHWAY 67
Mailing Address - Street 2:SUITE D
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2701
Mailing Address - Country:US
Mailing Address - Phone:972-270-8300
Mailing Address - Fax:972-270-4667
Practice Address - Street 1:3129 US HIGHWAY 67
Practice Address - Street 2:SUITE D
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2701
Practice Address - Country:US
Practice Address - Phone:972-270-8300
Practice Address - Fax:972-270-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXOO9155251E00000X
TX009155251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679190Medicare ID - Type Unspecified