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General NPI Number Information
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NPI Number | 1699135418
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Entity Type | Individual
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Provider Name | RADCLIFFE MYERS FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 1201 S ALLEN GENOA RD
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City | SOUTH HOUSTON
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State | TX
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Zip | 77587-4464
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Country | US
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Telephone | 713-667-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 9715 DRY CREEK CT
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City | RICHMOND
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State | TX
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Zip | 77469-2084
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Country | US
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Telephone | 210-441-0851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP129527
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License Number State | TX
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