Divine Glow Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DIVINE GLOW HEALTH LLC

Practice address

14090 Southwest Fwy Ste 300
Sugar Land, TX 77478-3679

Phone

(800) 645-0865

Fax

(800) 645-0866

NPI assigned

Dec 13, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Frances Ebo, NP, DNPNPI 1407202765

Title

President

Phone

(832) 428-8393

Specialties & licenses 10

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frances Ebo, NP-C

  • Family Nurse Practitioner
  • Sugar Land, TX
  • NPI 1407202765
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1790592632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14090 SOUTHWEST FWY STE 300",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783679",
            "telephone_number": "800-645-0865",
            "fax_number": "800-645-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14090 SOUTHWEST FWY STE 300",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783679",
            "telephone_number": "800-645-0865",
            "fax_number": "800-645-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GLOW HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "EBO",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-428-8393",
        "authorized_official_credential": "NP, DNP"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.