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General NPI Number Information
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NPI Number | 1063002632
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Entity Type | Organization
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Legal Business Name | REVERENCE EQUALITY HEALTHCARE LLC
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 11811 NORTH FWY STE 100
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City | HOUSTON
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State | TX
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Zip | 77060-3244
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Country | US
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Telephone | 346-329-3181
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Fax | 832-558-9059
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Provider Business Mailing Address
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Address Line | 19211 SPRINGERTON CIR
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City | SPRING
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State | TX
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Zip | 77373-8414
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Country | US
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Telephone | 346-329-3181
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Fax | 832-558-9058
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Authorized Official
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Title or Position | CEO
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Name | UMECCA DIANE COWART
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Credential | FNP-C
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Telephone | 313-207-5134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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