Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | T2694 | TX |
N | 207QS0010X | Family Doctor - Sports Medicine | T2694 | TX |
NPI | 1114345394 |
---|---|
Provider Name | Chenai Saaku Nettey |
First Address | El Paso, TX 79905-1613 |
Second Address | El Paso, TX 79924-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 03/08/2021 |