Godsgrace | |
3610 W Pioneer Pkwy Ste 103 Pantego TX 76013-4502 | |
(469) 254-5166 | |
Not Available |
Full Name | Godsgrace |
---|---|
Speciality | Secured Medical Transport (van) |
Location | 3610 W Pioneer Pkwy Ste 103, Pantego, Texas |
Authorized Official Name and Position | Abiola Hammed Odu (OWNER) |
Authorized Official Contact | 4692545166 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Godsgrace 2212 E Park Row Dr Apt L Arlington TX 76010-4816 Ph: (469) 254-5166 | Godsgrace 3610 W Pioneer Pkwy Ste 103 Pantego TX 76013-4502 Ph: (469) 254-5166 |
NPI Number | 1023718491 |
---|---|
Provider Enumeration Date | 03/06/2023 |
Last Update Date | 03/08/2023 |
Certification Date | 03/08/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023718491 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Secondary |
172A00000X | Driver | (* (Not Available)) | Secondary |
343800000X | Secured Medical Transport (van) | (* (Not Available)) | Primary |
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