Organization
GREEN WOMAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN SULLIVAN LMT (CEO)
(281) 573-4200
Entity
Organization
Contact information
Practice address
15838 FM 2354 RD, SUITE C, BEACH CITY, TX 77523
(281) 573-4200
Mailing address
15838 FM 2354 RD, SUITE C, BEACH CITY, TX 77523
(281) 573-4200
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
225700000X
TX
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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