Individual
LATISHICA EADEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2618 MERGANSER CT, HUMBLE, TX 77396-4148
(346) 719-3814
Mailing address
2618 MERGANSER CT, HUMBLE, TX 77396-4148
(346) 719-3814
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
006355
TX
Other
Enumeration date
12/11/2018
Last updated
12/11/2018
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