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General NPI Number Information
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NPI Number | 1609468198
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Entity Type | Organization
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Legal Business Name | ELOHIM'S GLORY HOUSE CALLS LLC
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Dates
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Enumeration Date | 02/07/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 17350 STATE HIGHWAY 249 STE 220
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City | HOUSTON
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State | TX
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Zip | 77064-1132
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Country | US
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Telephone | 409-203-5141
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Fax | 551-236-2496
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Provider Business Mailing Address
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Address Line | 8644 GLEN MEADOW LN
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City | BEAUMONT
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State | TX
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Zip | 77706-3935
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Country | US
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Telephone | 832-628-1452
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Fax | 551-236-2496
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Authorized Official
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Title or Position | CEO
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Name | LAKESHIA WILLIAMS
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Credential | FNP-C
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Telephone | 409-203-5141
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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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