Provider Demographics
NPI:1225812498
Name:CHIURI, GRACE MILKA MUTHONI
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:MILKA MUTHONI
Last Name:CHIURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11002 SHETTLESTON DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2811
Mailing Address - Country:US
Mailing Address - Phone:254-415-0266
Mailing Address - Fax:
Practice Address - Street 1:11002 SHETTLESTON DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2811
Practice Address - Country:US
Practice Address - Phone:254-415-0266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health