Individual
BRENT R WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1712 N FRAZIER ST STE 208, CONROE, TX 77301-1380
(936) 445-9512
Mailing address
500 HICKERSON ST APT 702, CONROE, TX 77301-2791
(193) 644-5951
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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