| Kingdom House Calls | |
|
2209 Alabama St Apt A Houston TX 77004-4380 | |
| (832) 577-7925 | |
| Not Available |
| Full Name | Kingdom House Calls |
|---|---|
| Speciality | Internal Medicine |
| Location | 2209 Alabama St Apt A, Houston, Texas |
| Authorized Official Name and Position | Gina Cowan (COO) |
| Authorized Official Contact | 8325777925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom House Calls 2209 Alabama St Apt A Houston TX 77004-4380 Ph: (832) 577-7925 | Kingdom House Calls 2209 Alabama St Apt A Houston TX 77004-4380 Ph: (832) 577-7925 |
| NPI Number | 1902597537 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 06/13/2023 |
| Medicare PECOS PAC ID | 5991150971 |
|---|---|
| Medicare Enrollment ID | O20231011001352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902597537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Ronald Bryant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265420970 PECOS PAC ID: 9537057393 Enrollment ID: I20050809000055 |
| Provider Name | Loretta Bennam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518520659 PECOS PAC ID: 6507195781 Enrollment ID: I20190913000493 |
| Provider Name | Roy Daniel Pendergraft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154430791 PECOS PAC ID: 4587095948 Enrollment ID: I20200519001508 |
| Provider Name | Lindsay Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033639810 PECOS PAC ID: 0446519466 Enrollment ID: I20201214002198 |
| Provider Name | Edith E Emenike Ogboru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447403613 PECOS PAC ID: 9335543701 Enrollment ID: I20210806001048 |
| Provider Name | Jessica Elizondo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992456578 PECOS PAC ID: 1850745613 Enrollment ID: I20230927002315 |
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