| Ebony Washington | |
|
11329 N Sam Houston Pkwy E Humble TX 77396-4598 | |
| (281) 835-4449 | |
| (281) 835-4236 |
| Full Name | Ebony Washington |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 11329 N Sam Houston Pkwy E, Humble, Texas |
| Authorized Official Name and Position | Ebony Patrice Washington (SOLE PROPRIETOR) |
| Authorized Official Contact | 3184611461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebony Washington 8831 Misty Meadow Creek Ln Humble TX 77338-5181 Ph: (318) 461-1461 | Ebony Washington 11329 N Sam Houston Pkwy E Humble TX 77396-4598 Ph: (281) 835-4449 |
| NPI Number | 1104303510 |
|---|---|
| Provider Enumeration Date | 07/27/2018 |
| Last Update Date | 04/27/2022 |
| Medicare PECOS PAC ID | 5890044515 |
|---|---|
| Medicare Enrollment ID | O20180814001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104303510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Ebony P Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972988319 PECOS PAC ID: 8224327499 Enrollment ID: I20160512000269 |
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