Organization
IMPACT HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINE PATILLO NP (CO-OWNER)
(832) 790-3070
Entity
Organization
Contact information
Practice address
9114 WHEAT CROSS DR, HOUSTON, TX 77095-5215
(832) 790-3070
Mailing address
9114 WHEAT CROSS DR, HOUSTON, TX 77095-5215
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689109779
—
TX
Enumeration date
02/23/2023
Last updated
02/23/2023
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