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Ch Stafford LLC

Nurse Practitioner, Family in Stafford, TX. Organization (NPI-2).

NPI number1467335463
StatusActive
Last updated in NPPESJul 28, 2025

Details

NPI
1467335463
Entity type
Organization (NPI-2)
Legal business name
Ch Stafford LLC
Organization subpart
No
Enumeration date
Jul 28, 2025
Certification date
Jul 28, 2025
Last updated
Jul 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family––Yes

Other names

  • Clinica Universo Latino (Doing Business As)

Practice location

112 Avenue F Ste B
Stafford, TX 77477-5502

Phone 281-499-1121 · Fax 281-499-1171

Mailing address

112 Avenue F Ste B
Stafford, TX 77477-5502

Phone 281-499-1121

Authorized official

Reynol Ramon Polanco Soriano
Fnp
8328757716

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