| Integrated Community Care Network Llc | |
|
2420 Fannin St Houston TX 77002-9114 | |
| (281) 687-3413 | |
| (832) 831-3652 |
| Full Name | Integrated Community Care Network Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2420 Fannin St, Houston, Texas |
| Authorized Official Name and Position | Angela Okotie-eboh (CEO) |
| Authorized Official Contact | 8328313651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Community Care Network Llc 16520 Steinhagen Rd Cypress TX 77429-7173 Ph: (281) 687-3413 | Integrated Community Care Network Llc 2420 Fannin St Houston TX 77002-9114 Ph: (281) 687-3413 |
| NPI Number | 1114651767 |
|---|---|
| Provider Enumeration Date | 07/11/2022 |
| Last Update Date | 07/07/2024 |
| Certification Date | 07/07/2024 |
| Medicare PECOS PAC ID | 4183097207 |
|---|---|
| Medicare Enrollment ID | O20230309003033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114651767 | NPI | - | NPPES |
| Provider Name | Angela I Okotie Eboh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851406573 PECOS PAC ID: 0446282495 Enrollment ID: I20050909000936 |
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