Organization
GRAPEVINE FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADETOKUNBOH ADE OMIGIE (OWNER)
(713) 434-9270
Entity
Organization
Contact information
Practice address
14522 S POST OAK RD, SUITE 203B, HOUSTON, TX 77045-6037
(713) 434-9270
Mailing address
14522 S POST OAK RD, SUITE 203B, HOUSTON, TX 77045-6037
(713) 434-9270
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2008
Last updated
03/09/2009
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