El Shaddai Family Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

733997 Issued in TX

Legal business name

EL SHADDAI FAMILY CLINIC LLC

Practice address

1740 W Virginia St Ste 400
McKinney, TX 75069-7864

Phone

(469) 252-0101

NPI assigned

Nov 15, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Beena Paul, NP-CNPI 1568773893

Title

Nurse Practitioner

Phone

(469) 252-0101

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beena Paul, NP

  • Family Nurse Practitioner
  • McKinney, TX
  • NPI 1568773893
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1447680178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W VIRGINIA ST STE 400",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750697864",
            "telephone_number": "469-252-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W VIRGINIA ST STE 400",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750697864",
            "telephone_number": "469-252-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL SHADDAI FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "BEENA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "469-252-0101",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "733997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1568773893",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Edwards, LCSW
• Shakirat Ololade Egbebi
• Maria Chiegeonu Egbirika
• Eileen Lin Chen, DDS, PLLC
• Tamela D El Habachi, MS, CCC SLP
• Elata Health and Wellness, LLC
• Eldorado Chiropractic, P.L.L.C.
• Eldorado Orthodontics PLLC
• Eldorado Vision & Optical, PLLC
• Elect Services Inc.

• Family Nurse Practitioner in McKinney, TX
• Providers in McKinney, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.