Destiny Family and Pediatric Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DESTINY FAMILY AND PEDIATRIC CLINIC

Practice address

4006 Creek Ridge LN
Missouri City, TX 77459-2342

Phone

(832) 274-5457

NPI assigned

Oct 3, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Linus N Nwanna, NURSE

Title

Registered Nurse/Administrator

Phone

(832) 274-5457

Specialties & licenses 1

Addresses

Practitioners 1

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

• Anthonia Nwanna, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Missouri City, TX
  • NPI 1689083875
  NPD (past)

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

{
    "created_epoch": "1443830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443830400000",
    "number": "1912377979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 CREEK RIDGE LN",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 CREEK RIDGE LN",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774592342",
            "telephone_number": "832-274-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY FAMILY AND PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-03",
        "last_updated": "2015-10-03",
        "status": "A",
        "authorized_official_last_name": "NWANNA",
        "authorized_official_first_name": "LINUS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "REGISTERED NURSE/ADMINISTRATOR",
        "authorized_official_telephone_number": "832-274-5457",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NURSE"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hagop Vahe Derkhorenian, R.PH.
• Desafary Healthcare Inc
• Komal Desai
• Neesha Desai
• Destined Hands Home Health Incorporated
• Desuna Care Services Inc
• Elizabeth Dexter
• Dhawkins Enterprises LLC
• Diamond Dialysis - Missouri City LLC
• Diamond Sleep Lab, Inc

• Primary Care Clinic/Center in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2015; 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.