Provider Demographics
NPI:1871920785
Name:NLUC PLLC
Entity type:Organization
Organization Name:NLUC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:S
Authorized Official - Last Name:BREEZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-201-0657
Mailing Address - Street 1:16107 KENSINGTON DR
Mailing Address - Street 2:SUITE 126
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4224
Mailing Address - Country:US
Mailing Address - Phone:281-201-0657
Mailing Address - Fax:281-336-0764
Practice Address - Street 1:10705 SPRING GREEN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-201-0657
Practice Address - Fax:713-621-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0096YROtherBCBS
TX0096YROtherBCBS