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NPI Code Detail

MEDICARE: PICC HEALTH INSTITUTE LLC

MEDICARE: PICC HEALTH INSTITUTE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1341600000XAmbulance
2261Q00000XClinic/Center

General Provider Information

NPI Number : 1306209739
Entity Type Code : Organization
Provider Name (Legal Business Name) : PICC HEALTH INSTITUTE LLC
Provider Business Mailing Address
First Line : 6260 WESTPARK DR STE 266
Second Line :
City : HOUSTON
State : TX
Zip : 77057-7353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6260 WESTPARK DR STE 266
Second Line :
City : HOUSTON
State : TX
Zip : 77057-7353
Country : US
Telephone Number : 713-828-3939
Fax Number :
Authorized Official
Title or Position : ARNP
Name : OPEYEMI OLOWOSUSI
Credential : FNP
Telephone Number : 713-828-3939
Provider Enumeration Date : 04/02/2016
Last Update Date : 04/02/2016

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Directions to “PICC HEALTH INSTITUTE LLC ” Practice Location

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