Provider Demographics
NPI:1508577537
Name:PALMER-IKUKU, FLORA
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:
Last Name:PALMER-IKUKU
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 1:18300 KATY FWY STE 305
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1521
Mailing Address - Country:US
Mailing Address - Phone:832-522-8520
Mailing Address - Fax:832-522-8524
Practice Address - Street 1:18300 KATY FWY STE 305
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1521
Practice Address - Country:US
Practice Address - Phone:832-522-8520
Practice Address - Fax:832-522-8524
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099702363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner