Healthcare Provider Details

I. General information

NPI: 1720684558
Provider Name (Legal Business Name): HEART OF HOUSTON MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 MAPLERIDGE ST STE 100
HOUSTON TX
77081-4629
US

IV. Provider business mailing address

6550 MAPLERIDGE ST STE 100
HOUSTON TX
77081-4629
US

V. Phone/Fax

Practice location:
  • Phone: 832-899-4971
  • Fax:
Mailing address:
  • Phone: 832-899-4971
  • Fax: 832-569-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: MARY LOVE
Title or Position: CLINICAL DIRECTOR,
Credential: APRN, CNM, NP-C
Phone: 832-899-4971