Adult & Geriatric Wholistic Health LLC
Nurse Practitioner, Psych/Mental Health in Stafford, TX. Organization (NPI-2).
NPI number1205642915
StatusActive
Last updated in NPPESDec 6, 2024
Details
- NPI
- 1205642915
- Entity type
- Organization (NPI-2)
- Legal business name
- Adult & Geriatric Wholistic Health LLC
- Organization subpart
- No
- Enumeration date
- Dec 6, 2024
- Certification date
- Dec 6, 2024
- Last updated
- Dec 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 363LG0600X | Nurse Practitioner, Gerontology | – | – |
Other names
- Adult & Geriatric Wholistic Health LLC (Doing Business As)
Practice location
647 S Marathon WayStafford, TX 77477-5841
Phone 832-908-8136
Mailing address
647 S Marathon WayStafford, TX 77477-5841
Phone 832-908-8136
Authorized official
Patricia Z Mbola
Manager
8329088136
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