| Gob Behavioral Health Pllc | |
|
190 Gulf Fwy S Ste 132b2 League City TX 77573-3588 | |
| (832) 643-4549 | |
| Not Available |
| Full Name | Gob Behavioral Health Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 190 Gulf Fwy S Ste 132b2, League City, Texas |
| Authorized Official Name and Position | Favour Onwukwe (OWNER/NP) |
| Authorized Official Contact | 8326434549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gob Behavioral Health Pllc 190 Gulf Fwy S Ste 132b2 League City TX 77573-3588 Ph: (832) 643-4549 | Gob Behavioral Health Pllc 190 Gulf Fwy S Ste 132b2 League City TX 77573-3588 Ph: (832) 643-4549 |
| NPI Number | 1740955053 |
|---|---|
| Provider Enumeration Date | 08/10/2021 |
| Last Update Date | 02/20/2025 |
| Certification Date | 02/20/2025 |
| Medicare PECOS PAC ID | 9032504261 |
|---|---|
| Medicare Enrollment ID | O20220324001737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740955053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Favour Onwukwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619641107 PECOS PAC ID: 7113312349 Enrollment ID: I20220324001824 |
| Provider Name | Ajikele Nwankwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205409042 PECOS PAC ID: 8022403252 Enrollment ID: I20220419001026 |
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