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General NPI Number Information
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NPI Number | 1467854539
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Entity Type | Organization
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Legal Business Name | NP-C CONCIERGE
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Dates
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Enumeration Date | 09/20/2014
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Last Update Date | 09/20/2014
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Provider Practice Location Address
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Address Line | 12965 WIREVINE LN 12965 WIREVINE LANE
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City | HOUSTON
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State | TX
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Zip | 77072-2157
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Country | US
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Telephone | 832-216-4751
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Fax |
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Provider Business Mailing Address
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Address Line | 12965 WIREVINE LN 12965 WIREVINE LANE
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City | HOUSTON
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State | TX
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Zip | 77072-2157
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Country | US
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Telephone | 832-216-4751
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHIOMA OSIBODU
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Credential | NP
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Telephone | 832-216-4751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 759225
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License Number State | TX
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