| Shining Stars Healthcare Services Llc | |
|
20507 Regal Shadow Ln Cypress TX 77433-5459 | |
| (281) 463-7794 | |
| Not Available |
| Full Name | Shining Stars Healthcare Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20507 Regal Shadow Ln, Cypress, Texas |
| Authorized Official Name and Position | Grace Amah (DIRECTOR) |
| Authorized Official Contact | 3464453387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shining Stars Healthcare Services Llc 20507 Regal Shadow Ln Cypress TX 77433-5459 Ph: (281) 463-7794 | Shining Stars Healthcare Services Llc 20507 Regal Shadow Ln Cypress TX 77433-5459 Ph: (281) 463-7794 |
| NPI Number | 1083387302 |
|---|---|
| Provider Enumeration Date | 08/02/2021 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/01/2021 |
| Medicare PECOS PAC ID | 9335526524 |
|---|---|
| Medicare Enrollment ID | O20220509001364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083387302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
| Provider Name | Grace Chinenye Amah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043777923 PECOS PAC ID: 0648686733 Enrollment ID: I20210316001284 |
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