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General NPI Number Information
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NPI Number | 1508526922
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Entity Type | Organization
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Legal Business Name | FAMILY CLINIC A LIND, LLC
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Dates
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Enumeration Date | 12/27/2021
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 532 W NASA PKWY
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City | WEBSTER
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State | TX
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Zip | 77598-5127
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Country | US
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Telephone | 281-724-1423
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Fax | 281-724-1425
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Provider Business Mailing Address
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Address Line | 532 W NASA PKWY
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City | WEBSTER
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State | TX
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Zip | 77598-5127
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Country | US
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Telephone | 281-724-1423
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Fax | 281-724-1425
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Authorized Official
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Title or Position | OWNER/FNP
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Name | MILIZZA MARTIN
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Credential |
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Telephone | 281-724-1423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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