Healthcare Provider Details

I. General information

NPI: 1548880396
Provider Name (Legal Business Name): LEADING CROWN PROFESSIONAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 RAVEN FALLS LN
FRIENDSWOOD TX
77546-6072
US

IV. Provider business mailing address

2626 RAVEN FALLS LN
FRIENDSWOOD TX
77546-6072
US

V. Phone/Fax

Practice location:
  • Phone: 832-326-9028
  • Fax: 281-486-2096
Mailing address:
  • Phone: 832-326-9028
  • Fax: 281-486-2096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. VERONICA OKAFOR
Title or Position: OWNER
Credential: FNP
Phone: 832-326-9028