Individual
DONELLY IKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1205 BLAYDON CT, ROSENBERG, TX 77471-5687
(281) 818-0830
Mailing address
1205 BLAYDON CT, ROSENBERG, TX 77471-5687
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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