Provider Demographics
NPI:1386031367
Name:BAYOU CITY FAMILY NURSE PRACTICE HEALTH AND WELLNESS
Entity type:Organization
Organization Name:BAYOU CITY FAMILY NURSE PRACTICE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,FNP-BC
Authorized Official - Phone:832-524-4239
Mailing Address - Street 1:10311 CRIMSON CANYON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5432
Mailing Address - Country:US
Mailing Address - Phone:832-524-4239
Mailing Address - Fax:
Practice Address - Street 1:16630 IMPERIAL VALLEY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3409
Practice Address - Country:US
Practice Address - Phone:832-524-4239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110649261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center