Provider Demographics
NPI:1457088957
Name:ACEVEDO-PARKER, GIGI
Entity type:Individual
Prefix:
First Name:GIGI
Middle Name:
Last Name:ACEVEDO-PARKER
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 1:700 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2714
Mailing Address - Country:US
Mailing Address - Phone:800-893-9419
Mailing Address - Fax:
Practice Address - Street 1:2719 LAKESIDE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4348
Practice Address - Country:US
Practice Address - Phone:708-515-6261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX857296163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management