Provider Demographics
NPI:1700448321
Name:GREENFIELD HEALTH PLLC
Entity type:Organization
Organization Name:GREENFIELD HEALTH PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:NKOLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ILOANYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-786-9884
Mailing Address - Street 1:5323 MACQUARIE POINT LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4795
Mailing Address - Country:US
Mailing Address - Phone:832-786-9884
Mailing Address - Fax:281-754-4781
Practice Address - Street 1:5323 MACQUARIE POINT LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4795
Practice Address - Country:US
Practice Address - Phone:832-786-9884
Practice Address - Fax:281-754-4781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ2776OtherABIM