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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
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1477820553
Entity Type Code : Organization
Provider Name (Legal Business Name) : PICC HEALTH INSTITUTE LLC
Provider Business Mailing Address
First Line : 7324 SOUTHWEST FWY
Second Line : STE 885
City : HOUSTON
State : TX
Zip : 77074
Country : US
Telephone Number : 832-804-7825
Fax Number : 832-804-7837
Provider Business Practice Location Address
First Line : 5302 CANAL STREET
Second Line :
City : HOUSTON
State : TX
Zip : 77011
Country : US
Telephone Number : 713-534-1718
Fax Number : 713-640-5213
Authorized Official
Title or Position : MANAGING DIRECTOR
Name : NINA OLUGU
Credential :
Telephone Number : 713-534-1718
Provider Enumeration Date : 11/17/2011
Last Update Date : 12/08/2014

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Directions to “PICC HEALTH INSTITUTE LLC ” Practice Location

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