Provider Demographics
NPI:1750020830
Name:CREXMED
Entity Type:Organization
Organization Name:CREXMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:UCHE
Authorized Official - Middle Name:
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-397-3324
Mailing Address - Street 1:222 HONEYSUCKLE VINE DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5788
Mailing Address - Country:US
Mailing Address - Phone:713-397-3324
Mailing Address - Fax:
Practice Address - Street 1:24200 SOUTHWEST FWY, STE 402 #295
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471
Practice Address - Country:US
Practice Address - Phone:267-332-1053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty