Provider Demographics
NPI:1669614178
Name:ESTHER A. FAIRCHILD
Entity type:Organization
Organization Name:ESTHER A. FAIRCHILD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:FAIRCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA/WHNP
Authorized Official - Phone:940-453-2026
Mailing Address - Street 1:2121 WINDSOR FARMS DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-1294
Mailing Address - Country:US
Mailing Address - Phone:940-453-2026
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:2121 WINDSOR FARMS DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-1294
Practice Address - Country:US
Practice Address - Phone:940-453-2026
Practice Address - Fax:888-329-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX637964163WR0006X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0072SEOtherBCBS OF TEXAS
TX0072SEOtherBCBS OF TEXAS