Individual
IBISO COTTERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 DAIRY ASHFORD RD STE 560, HOUSTON, TX 77079-3035
(832) 352-8981
Mailing address
1155 DAIRY ASHFORD RD STE 560, HOUSTON, TX 77079-3035
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
348068
TX
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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