Provider Demographics
NPI:1013316611
Name:NARTEY, SHADRACH
Entity Type:Individual
Prefix:MR
First Name:SHADRACH
Middle Name:
Last Name:NARTEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 IH 30
Mailing Address - Street 2:SUITE 402
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2606
Mailing Address - Country:US
Mailing Address - Phone:469-804-4874
Mailing Address - Fax:
Practice Address - Street 1:3213 IH 30
Practice Address - Street 2:SUITE 402
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2606
Practice Address - Country:US
Practice Address - Phone:469-804-4874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor