MEDICARE: LEADING CROWN PROFESSIONAL GROUP, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WH1000X	Hospice Registered Nurse
2	163WI0500X	Infusion Therapy Registered Nurse
3	163WW0000X	Wound Care Registered Nurse
4	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
5	251F00000X	Home Infusion Agency
6	171400000X	Health & Wellness Coach
7	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1548880396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEADING CROWN PROFESSIONAL GROUP, PLLC

Provider Business Mailing Address
First Line	:	2626 RAVEN FALLS LN
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-6072
Country	:	US
Telephone Number	:	832-326-9028
Fax Number	:	281-486-2096

Provider Business Practice Location Address
First Line	:	2626 RAVEN FALLS LN
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-6072
Country	:	US
Telephone Number	:	832-326-9028
Fax Number	:	281-486-2096

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. VERONICA OKAFOR
Credential	:	FNP
Telephone Number	:	832-326-9028

Provider Enumeration Date	:	04/22/2020
Last Update Date	:	05/03/2021

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Directions to “LEADING CROWN PROFESSIONAL GROUP, PLLC ” Practice Location

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