Organization · Type 2 NPI

Nurse Practitioner Provider

Health Service Clinic/Center · Houston, TX

NPI number 1053624015 Active

Practice location

2626 S Loop W, 350
Houston, TX 77054-2654

Mailing address

16731 Bethan Glen Ln
Houston, TX 77084-2651

Specialties and licenses

TaxonomyCodeLicense
Health Service Clinic/Center Primary 261QH0100XNone listed

Health Service Clinic/Center: Definition to come...

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About NPI 1053624015

Nurse Practitioner Provider's National Provider Identifier is 1053624015, issued on Jul 20, 2010. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Houston, TX. The record was last updated on Jul 20, 2010.