NPI 1417308966

Good Grace Provider Service

Organisation PACE Provider Organization Houston, TX

Practice location

Address: 15155 Richmond Ave APT 833, Houston, TX 77082-1637
Phone: (832) 890-5451
Fax: (832) 210-2210
Mailing address: 15155 Richmond Ave APT 833, Houston, TX 77082

Authorised official

Name: Cynthia Maria Gonzalez
Title: Owner
Phone: (832) 890-5451

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

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Registry record

NPI: 1417308966
Entity type: Organization
NPI issued: 27 Jun 2016
Record last updated: 27 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.