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General NPI Number Information
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NPI Number | 1780271619
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Entity Type | Organization
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Legal Business Name | CLINICA HISPANA GLORIA DE AMERICA #2
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Dates
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Enumeration Date | 12/27/2020
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 802 RANKIN RD # B4
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City | HOUSTON
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State | TX
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Zip | 77073-4602
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Country | US
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Telephone | 832-827-2726
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Fax | 832-827-2716
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Provider Business Mailing Address
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Address Line | 802 RANKIN RD # B4
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City | HOUSTON
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State | TX
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Zip | 77073-4602
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Country | US
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Telephone | 832-827-2726
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Fax | 832-827-2716
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MANUEL DE LAS MERCEDES GUERRA BAZAN
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Credential | RN
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Telephone | 832-827-2726
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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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