Provider Demographics
NPI:1699418756
Name:GRADIENT ASSOCIATES
Entity type:Organization
Organization Name:GRADIENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF
Authorized Official - Prefix:
Authorized Official - First Name:BACK
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:737-787-1905
Mailing Address - Street 1:3728 DACOMA ST STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3728 DACOMA ST STE 160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8906
Practice Address - Country:US
Practice Address - Phone:737-787-1905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center