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General NPI Number Information
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NPI Number | 1669713905
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Entity Type | Organization
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Legal Business Name | G-B & R URBAN ENTERPRISES, LLC
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 1830 WOODVINE DR
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City | HOUSTON
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State | TX
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Zip | 77055-2515
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Country | US
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Telephone | 713-481-2555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55961
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City | HOUSTON
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State | TX
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Zip | 77255-5961
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NITRA GIPSON
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Credential |
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Telephone | 832-627-2621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 015706
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License Number State | TX
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