Provider Demographics
NPI:1063979441
Name:ESTRADA & ESTRADA LLC
Entity type:Organization
Organization Name:ESTRADA & ESTRADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:432-230-0110
Mailing Address - Street 1:8308 INSPIRATION LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-8599
Mailing Address - Country:US
Mailing Address - Phone:432-230-0110
Mailing Address - Fax:
Practice Address - Street 1:3425 GRANDE BULEVAR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5108
Practice Address - Country:US
Practice Address - Phone:972-639-5836
Practice Address - Fax:469-586-4761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare