MEDICARE: JAMES RONK AGNP-C

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
1	363LP2300X	Primary Care Nurse Practitioner	1107547	TX
2	363LG0600X	Gerontology Nurse Practitioner	1107541	TX

General Provider Information

NPI Number	:	1396450425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RONK AGNP-C

Provider Business Mailing Address
First Line	:	5000 MONTROSE BLVD UNIT 18C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-6563
Country	:	US
Telephone Number	:	205-245-3411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1244 UVALDE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-3708
Country	:	US
Telephone Number	:	281-707-7354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2023
Last Update Date	:	02/15/2024

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