Provider Demographics
NPI:1831875145
Name:ESSENTIAL PRIMARY CARE LLC
Entity type:Organization
Organization Name:ESSENTIAL PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGEBE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:240-701-4605
Mailing Address - Street 1:21426 AVALON QUEEN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-5910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2833 SPEARS RD STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-1170
Practice Address - Country:US
Practice Address - Phone:240-701-4605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty