Provider Demographics
NPI:1184349482
Name:WEZE, DEBBIE EZINWANYI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:EZINWANYI
Last Name:WEZE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:EZINWANYI
Other - Last Name:WEZE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:539 W COMMERCE ST STE 4518
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1953
Mailing Address - Country:US
Mailing Address - Phone:832-566-7028
Mailing Address - Fax:
Practice Address - Street 1:539 W COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:832-566-7028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078657363LP0808X
WAAP61466845363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health