Individual
CRYSTAL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 704-4000
Mailing address
3300 16TH ST NW APT 813, WASHINGTON, DC 20010-2259
(301) 706-1734
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1103075
TX
Other
Enumeration date
03/16/2023
Last updated
03/19/2023
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