# IMPACT HEALTHCARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144929639
- **Authorized official:** REGINE PATILLO NP (CO-OWNER)
- **Authorized official phone:** (832) 790-3070

## Contact information

- **Practice address:** 9114 WHEAT CROSS DR, HOUSTON, TX 77095-5215
- **Practice address phone:** (832) 790-3070
- **Mailing address:** 9114 WHEAT CROSS DR, HOUSTON, TX 77095-5215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2023
- **Last updated:** 02/23/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1689109779 | — | TX |