Provider Demographics
NPI:1831633973
Name:NDICHU, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:NDICHU
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 1:6302 MEADOWBROOK DR STE 112
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-5163
Mailing Address - Country:US
Mailing Address - Phone:817-446-0800
Mailing Address - Fax:
Practice Address - Street 1:601 BROWN TRL APT 131
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-5791
Practice Address - Country:US
Practice Address - Phone:205-222-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131836363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily