Active NPI
Cecilia Efuetlacha
- Registered Nurse
- Coppell, TX
National Provider Identifier
1326605478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 74055
- Practice address
- 625 Parkway Blvd
Coppell, TX 75019-6087 - Phone
- (469) 544-3579
- NPI assigned
- May 23, 2019
- Last updated
- May 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 74055 | ME | Primary |
Addresses
Primary practice location
625 Parkway Blvd
Coppell, TX 75019-6087
Mailing address
625 Parkway Blvd
Coppell, TX 75019-6087
Phone (469) 544-3579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74055 | ME | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1326605478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 PARKWAY BLVD",
"city": "COPPELL",
"state": "TX",
"postal_code": "750196087",
"telephone_number": "469-544-3579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 PARKWAY BLVD",
"city": "COPPELL",
"state": "TX",
"postal_code": "750196087",
"telephone_number": "469-544-3579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EFUETLACHA",
"first_name": "CECILIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-23",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ME",
"license": "74055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.