Provider Demographics
NPI:1619512977
Name:ESTHER JOSEPH, MODUPE D (LVN)
Entity type:Individual
Prefix:MS
First Name:MODUPE
Middle Name:D
Last Name:ESTHER JOSEPH
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 SUNNY ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3267
Mailing Address - Country:US
Mailing Address - Phone:224-523-0117
Mailing Address - Fax:
Practice Address - Street 1:3715 SUNNY ORCHARD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3267
Practice Address - Country:US
Practice Address - Phone:224-523-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224017164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse