Provider Demographics
NPI:1841734977
Name:AICON FAMILY CLINIC LLC
Entity Type:Organization
Organization Name:AICON FAMILY CLINIC LLC
Other - Org Name:AICON FAMILY CLINIC LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:KINDNESS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHUKWUKERE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:281-704-2922
Mailing Address - Street 1:16261 FM 529 RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1433
Mailing Address - Country:US
Mailing Address - Phone:281-704-2922
Mailing Address - Fax:
Practice Address - Street 1:16261 FM 529 RD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSOTN
Practice Address - State:TX
Practice Address - Zip Code:77095
Practice Address - Country:US
Practice Address - Phone:281-704-2922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-08
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129295363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty