MEDICARE: NPC FAMILY HEALTH CLINIC PC

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	363LF0000X	Family Nurse Practitioner	620452	TX

General Provider Information

NPI Number	:	1528321791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NPC FAMILY HEALTH CLINIC PC

Provider Business Mailing Address
First Line	:	412 N SAM HOUSTON PKWY E STE H
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3508
Country	:	US
Telephone Number	:	281-260-6622
Fax Number	:	281-260-6688

Provider Business Practice Location Address
First Line	:	412 N SAM HOUSTON PKWY E STE H
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3508
Country	:	US
Telephone Number	:	281-260-6622
Fax Number	:	281-260-6688

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	PROF. LUTRICIA HARRISON
Credential	:	FNP-BC
Telephone Number	:	281-260-6622

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	09/14/2012

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