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General NPI Number Information
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NPI Number | 1386031367
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Entity Type | Organization
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Legal Business Name | BAYOU CITY FAMILY NURSE PRACTICE HEALTH AND WELLNESS
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Dates
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Enumeration Date | 04/17/2015
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 16630 IMPERIAL VALLEY DR SUITE 101
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City | HOUSTON
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State | TX
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Zip | 77060-3409
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Country | US
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Telephone | 832-524-4239
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Fax |
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Provider Business Mailing Address
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Address Line | 10311 CRIMSON CANYON DR
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City | HOUSTON
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State | TX
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Zip | 77095-5432
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Country | US
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Telephone | 832-524-4239
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VERONICA SMITH
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Credential | DNP,FNP-BC
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Telephone | 832-524-4239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AP110649
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License Number State | TX
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