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General NPI Number Information
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NPI Number | 1780246512
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Entity Type | Organization
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Legal Business Name | PRACTITIONERS IN ALLIANCE
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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Provider Practice Location Address
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Address Line | 27027 BARRINGTON LODGE LN
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City | KATY
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State | TX
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Zip | 77494-2725
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Country | US
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Telephone | 832-475-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 27027 BARRINGTON LODGE LN
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City | KATY
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State | TX
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Zip | 77494-2725
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Country | US
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Telephone | 832-475-8787
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Fax |
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Authorized Official
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Title or Position | FNP-C
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Name | MISS MERCY GATHOGO
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Credential | APRN
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Telephone | 832-475-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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