Healthcare Provider Details

I. General information

NPI: 1174760680
Provider Name (Legal Business Name): GOVE FAMILY PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 DUBLIN DR
LEAGUE CITY TX
77573-4972
US

IV. Provider business mailing address

1802 DUBLIN DR
LEAGUE CITY TX
77573-4972
US

V. Phone/Fax

Practice location:
  • Phone: 713-818-5800
  • Fax:
Mailing address:
  • Phone: 713-818-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number801073394
License Number StateTX

VIII. Authorized Official

Name: MR. STEVE THOMAS GOVE
Title or Position: PRESIDENT/OWNER
Credential: FNP
Phone: 713-818-5800