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General NPI Number Information
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NPI Number | 1043537012
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Entity Type | Organization
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Legal Business Name | THREE ANGELS MEDICAL CLINIC INC.
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 7111 HARWIN DR SUITE# 277
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City | HOUSTON
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State | TX
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Zip | 77036-2129
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Country | US
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Telephone | 832-382-3422
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Fax | 281-597-0262
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Provider Business Mailing Address
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Address Line | 7111 HARWIN DR SUITE# 277
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City | HOUSTON
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State | TX
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Zip | 77036-2129
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Country | US
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Telephone | 832-382-3422
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Fax | 281-597-0262
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | GRACE J. MUNTHALI
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Credential | RN.
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Telephone | 832-382-3422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | 7033345
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License Number State | TX
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