Provider Demographics
NPI:1194415356
Name:ZHU, WENFANG
Entity type:Individual
Prefix:MRS
First Name:WENFANG
Middle Name:
Last Name:ZHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:ZHU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6229 BRAZOZ EICWE ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932
Mailing Address - Country:US
Mailing Address - Phone:520-595-9391
Mailing Address - Fax:
Practice Address - Street 1:6351 S DESERT BLVD
Practice Address - Street 2:STE 106
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932
Practice Address - Country:US
Practice Address - Phone:520-595-9391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA-0019018097225700000X
AZMT-21906225700000X
TXMT-137983225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist