| Na | |
|
6722 Walnut Sq Richmond TX 77469-7550 | |
| (713) 516-6662 | |
| Not Available |
| Full Name | Na |
|---|---|
| Speciality | Counselor |
| Location | 6722 Walnut Sq, Richmond, Texas |
| Authorized Official Name and Position | Chris Okwuchukwu Igwilo (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7135166662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Na 6722 Walnut Sq Richmond TX 77469-7550 Ph: (713) 516-6662 | Na 6722 Walnut Sq Richmond TX 77469-7550 Ph: (713) 516-6662 |
| NPI Number | 1568564235 |
|---|---|
| Provider Enumeration Date | 09/02/2006 |
| Last Update Date | 09/10/2007 |
| Medicare PECOS PAC ID | 5294172094 |
|---|---|
| Medicare Enrollment ID | O20240327003966 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568564235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 18951 (Texas) | Primary |
| Provider Name | Chris Okwuchukwu Igwilo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205015104 PECOS PAC ID: 6800239138 Enrollment ID: I20240328002232 |
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