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General NPI Number Information
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NPI Number | 1780946301
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Entity Type | Organization
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Legal Business Name | KBBR INC.
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 01/11/2014
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Provider Practice Location Address
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Address Line | 14526 OLD KATY RD SUITE 220
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City | HOUSTON
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State | TX
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Zip | 77079-1021
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Country | US
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Telephone | 281-531-0661
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Fax | 281-531-0665
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Provider Business Mailing Address
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Address Line | 14526 OLD KATY RD SUITE 220
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City | HOUSTON
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State | TX
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Zip | 77079-1021
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Country | US
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Telephone | 281-531-0661
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | CRYSTAL RAY NWABOH
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Credential | NURSE PRACTITIONER
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Telephone | 281-531-0661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 696808
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License Number State | TX
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