Healthcare Provider Details

I. General information

NPI: 1225958929
Provider Name (Legal Business Name): VERONICA HOUSE CLARK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VERONICA NICHOLE HOUSE RN

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 W 71ST ST
INDIANAPOLIS IN
46268-2967
US

IV. Provider business mailing address

12922 PALE IVY LN
HOUSTON TX
77072-5641
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-0151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number761740
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: