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General NPI Number Information
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NPI Number | 1154919892
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Entity Type | Organization
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Legal Business Name | NOVA FAMILY HEALTH AND WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 09/05/2021
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Provider Practice Location Address
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Address Line | 1001 S DAIRY ASHFORD RD STE 100-171
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City | HOUSTON
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State | TX
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Zip | 77077-2375
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Country | US
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Telephone | 614-599-3900
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Fax | 281-346-8625
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Provider Business Mailing Address
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Address Line | 29127 GARDEN RIVER CT
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City | FULSHEAR
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State | TX
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Zip | 77441-1778
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Country | US
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Telephone | 161-459-9390
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDITH EMENIKE - OGBORU
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Credential | FNP
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Telephone | 614-599-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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