Provider Demographics
NPI:1770226045
Name:NLUC PLLC
Entity Type:Organization
Organization Name:NLUC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:S
Authorized Official - Last Name:BREEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-201-0657
Mailing Address - Street 1:2925 BRIARPARK DR STE 575
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3776
Mailing Address - Country:US
Mailing Address - Phone:281-783-8162
Mailing Address - Fax:
Practice Address - Street 1:14900 N INTERSTATE HWY 35 STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-5777
Practice Address - Country:US
Practice Address - Phone:281-783-8162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK1981OtherLICENSE