Provider Demographics
NPI:1720124282
Name:BROOMSEY, ZEFFERINE
Entity Type:Individual
Prefix:
First Name:ZEFFERINE
Middle Name:
Last Name:BROOMSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 EMBERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-3826
Mailing Address - Country:US
Mailing Address - Phone:972-228-4361
Mailing Address - Fax:
Practice Address - Street 1:920 EMBERWOOD DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-3826
Practice Address - Country:US
Practice Address - Phone:972-228-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116935310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility