STEDICLINIC PLLC (NPI# 1659746675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659746675 |
| Entity Type | Organization |
| Organization Name | STEDICLINIC PLLC |
| Practice Address |
4560 Fm 1960 Rd W Ste 106 Houston TX 77069 |
| Mailing Address |
4560 Fm 1960 Rd W Ste 106 Houston TX 77069-4628 |
| Practice Telephone | 8322861061 |
| Practice Fax Number | 8322861267 |
| Mailing Telephone | 8322861061 |
| Mailing Fax Number | 8322861267 |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2018-06-26 |
| Authorized Official Name | OLAYINKA AGBODO (FAMILY NURSE PRACTITIONER) |
| Authorized Official Telephone | 8327458742 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP128483 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP130092 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 261Q00000X | Clinic/Center | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 3604894 | 05 | |
| TX | 358389004 | 05 | |
| TX | 1659746675 | 05 |
| Street Address |
4560 FM 1960 RD W STE 106 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174080659 | Brittanny Lea Gormer | Behavior Technician | 4606 Farm To Market 1960 Rd W Suite 419, Houston, TX 77069 | 2019-02-21 |
| 1417452889 | Kenyatta Robinson | Nurse Practitioner | 5603 Farm To Market 1960 Rd W, Houston, TX 77069 | 2018-03-28 |
| 1962921155 | Chew Transportation | Non-emergency Medical Transport (VAN) | 13313 Cutten Rd., Apt. 2203, Houston, TX 77069 | 2017-09-19 |
| 1639697071 | Nancy Wade | Behavior Technician | 13313 Cutten Rd. Apt. 2203, Houston, TX 77069 | 2017-09-06 |
| 1649716432 | Fresh Start Therapeutic Services LLC | Counselor | 5222 Fm 1960 Rd W Ste 175, Houston, TX 77069 | 2017-01-17 |
| 1568919017 | Jasmine Ned | Home Health Aide | 5959 1960 W Rd, Apt 621, Houston, TX 77069 | 2016-09-01 |
| 1528415007 | Gracesprings Healthcare Services | Day Training, Developmentally Disabled Services | 4606 Fm 1960 Rd W, Ste 322, Houston, TX 77069 | 2016-05-16 |
| 1164887923 | Beatrice Huong Pham | Pharmacist | 7075 Fm1960 W., Houston, TX 77069 | 2015-12-22 |
| 1053719799 | Mann Eye Center, Pa | Optometrist | 6927 Fm 1960 West, Suite D, Houston, TX 77069 | 2014-12-11 |
| 1598166381 | 20-20 Express--houston LLC | Eyewear Supplier (Equipment, not the service) | 6927 Fm 1960 W, Houston, TX 77069 | 2014-09-11 |
| Find all providers in zip 77069 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477150688 | Sun Houston, LLC | Clinic/Center | 7505 Fannin St Ste 430, Houston, TX 77054-1944 | 2020-10-01 |
| 1912517426 | Med Cure Clinic | Clinic/Center | 102703 Alief Clodine Rd, Houston, TX 77082 | 2020-08-10 |
| 1417565425 | Tiny Tots Pediatric Home Health, LLC | Clinic/Center | 11023 Cape Rise Trl, Houston, TX 77044-5990 | 2020-07-15 |
| 1609494152 | Gmed Global LLC | Clinic/Center | 11110 Bellaire Blvd Ste 203, Houston, TX 77072-2610 | 2020-07-10 |
| 1063048288 | Brsi Lp | Clinic/Center | 1111 North Loop W Ste 1000, Houston, TX 77008-4717 | 2020-03-19 |
| 1861023384 | Medipoint Analysis | Clinic/Center | 3726 Dacoma St Ste 225, Houston, TX 77092-8906 | 2020-02-03 |
| 1306477765 | Bellora Health | Clinic/Center | 3726 Dacoma St Ste 240, Houston, TX 77092-8906 | 2020-02-03 |
| 1396376752 | Renova Medical | Clinic/Center | 3726 Dacoma St Ste 250, Houston, TX 77092-8906 | 2020-02-03 |
| 1861032955 | Complete Care Clinic | Clinic/Center | 507 N Sam Houston Pkwy E Ste 440, Houston, TX 77060-4007 | 2020-01-07 |
| 1316583719 | Sleep Wave Center LLC | Clinic/Center | 3400 Bissonnet St Ste 135, Houston, TX 77005-2163 | 2019-11-20 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.