Provider Demographics
NPI:1629704465
Name:FIRST ESSENTIAL FAMILY CLINIC & EMERGENCY CARE
Entity Type:Organization
Organization Name:FIRST ESSENTIAL FAMILY CLINIC & EMERGENCY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS-SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-372-6835
Mailing Address - Street 1:3129 KINGSLEY DR STE 620
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8508
Mailing Address - Country:US
Mailing Address - Phone:281-372-6835
Mailing Address - Fax:
Practice Address - Street 1:3129 KINGSLEY DR STE 620
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8508
Practice Address - Country:US
Practice Address - Phone:281-372-6835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical