Provider Demographics
NPI:1023853116
Name:FAMILI, ELNAZ
Entity type:Individual
Prefix:
First Name:ELNAZ
Middle Name:
Last Name:FAMILI
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 1:512 EAGLE WAY
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3908
Mailing Address - Country:US
Mailing Address - Phone:214-290-6470
Mailing Address - Fax:
Practice Address - Street 1:4601 OLD SHEPARD PL STE 405
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5278
Practice Address - Country:US
Practice Address - Phone:469-782-1888
Practice Address - Fax:469-782-1889
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty