Provider Demographics
NPI:1083372478
Name:WONACE
Entity Type:Organization
Organization Name:WONACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINBOBOLA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:832-877-2140
Mailing Address - Street 1:810 HIGHWAY 6 S STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4025
Mailing Address - Country:US
Mailing Address - Phone:281-810-3123
Mailing Address - Fax:
Practice Address - Street 1:810 HIGHWAY 6 S STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4025
Practice Address - Country:US
Practice Address - Phone:281-810-3123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies