Provider Demographics
NPI:1063129997
Name:OPULENCE HEALTH PLLC
Entity type:Organization
Organization Name:OPULENCE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-672-8026
Mailing Address - Street 1:1801 COUNTRY PLACE PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5121
Mailing Address - Country:US
Mailing Address - Phone:832-672-8026
Mailing Address - Fax:832-230-4172
Practice Address - Street 1:1801 COUNTRY PLACE PKWY STE 109
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5121
Practice Address - Country:US
Practice Address - Phone:832-672-8026
Practice Address - Fax:832-230-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1144562364OtherNPI