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General NPI Number Information
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NPI Number | 1720194376
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Entity Type | Organization
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Legal Business Name | GRACE PEDIATRICS AND FAMILY CLINIC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 9207 COUNTRY CREEK DR SUITE 206
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City | HOUSTON
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State | TX
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Zip | 77036-7714
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Country | US
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Telephone | 713-988-6835
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Fax | 713-988-5471
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Provider Business Mailing Address
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Address Line | 9207 COUNTRY CREEK DR SUITE 206
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City | HOUSTON
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State | TX
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Zip | 77036-7714
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Country | US
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Telephone | 713-988-6835
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Fax | 713-988-5471
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. ESTHER MGBEIKE
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Credential | NP
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Telephone | 713-988-6835
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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 | 638038
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License Number State | TX
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