Organization
NUROCOACH MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TACCARA ROSS (OFFICE MANAGER)
(225) 803-7877
Entity
Organization
Contact information
Practice address
101 SOUTHWESTERN BLVD STE 200, SUGAR LAND, TX 77478-3568
(855) 954-6876
(855) 859-6876
Mailing address
101 SOUTHWESTERN BLVD STE 200, SUGAR LAND, TX 77478-3568
(855) 954-6876
(855) 859-6876
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003291441A
—
GA
05
—
1174022248
—
TX
05
—
1235631599
—
TX
05
—
1902217581
—
LA
Enumeration date
08/18/2022
Last updated
08/28/2024
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