Provider Demographics
NPI:1154797801
Name:FUSION FAMILY CONSULTING
Entity type:Organization
Organization Name:FUSION FAMILY CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:AMEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-450-1457
Mailing Address - Street 1:1700 ALMA DR
Mailing Address - Street 2:STE 480
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6937
Mailing Address - Country:US
Mailing Address - Phone:469-344-1414
Mailing Address - Fax:
Practice Address - Street 1:1700 ALMA DR
Practice Address - Street 2:STE 480
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6937
Practice Address - Country:US
Practice Address - Phone:469-344-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5083174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316139850OtherNPPES